BACKGROUND/AIMS
The prevalence of gastric adenocarcinoma is 951.000 in the world and cases in Western countries are diagnosed in a more advanced stage. In this study, the efficacy of neoadjuvant chemotherapy in gastric cancer was demonstrated and neoadjuvant chemotherapy was recommended for patients with ≥T2 resectable gastric tumors. The key point for administering neoadjuvant chemotherapy is the distant location of a solid organ and the status of peritoneal metastasis at the beginning of the treatment. We aimed to investigate the effect of the peritoneal status, which is assessed using staging laparoscopy, on the treatment protocol of gastric cancer patients.
MATERIAL and METHODS
This retrospective study included 60 neoadjuvant chemotherapy patients, who were divided into 2 groups according to staging methods.
RESULTS
Out of a total of 60 patients, 30 were staged by radiological methods and staging laparoscopy prior to neoadjuvant chemotherapy. The remaining 30 patients were staged only by radiological methods. In the laparoscopic staged group, peritoneal metastases were detected in 43% of radiologically non-metastatic patients by staging laparoscopy. In the non-laparoscopic staged group, metastatic disease was identified in 7 patients, right before or during the gastrectomy operation.
CONCLUSION
Peritoneal metastasis is not uncommon in gastric cancer. If the evaluation of peritoneal status is made only by radiological examinations, the treatment may be started with an incorrect low-grade diagnosis. The use of staging laparoscopy prior to neoadjuvant chemotherapy makes a significant contribution to the multidisciplinary treatment of gastric cancer.
Keywords: Cancer staging, gastric cancer, Laparoscopy, neoadjuvant therapy, peritoneal carcinomatosis