Laparoscopy alone is superior to peritoneal cytology in staging gastric and esophageal carcinoma

M. B. Wilkiemeyer, S. C. Bieligk, R. Ashfaq, D. B. Jones, Robert V Rege, J. B. Fleming

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Background: Laparoscopy identifies metastatic disease in patients with upper gastrointestinal malignancies; however, it has been suggested that cytological examination of peritoneal washings may increase the diagnostic yield. We hypothesize that the addition of cytologic washings to a standardized staging laparoscopy is unnecessary for the identification of intraabdominal metastasis in patients with gastric/esophageal cancer. Methods: Forty patients with gastric/esophageal cancer were prospectively evaluated. Patients successfully underwent a diagnostic laparoscopy protocol (with biopsies) during which peritoneal washings were obtained and processed for cytologic analysis. Laparoscopic versus cytologic identification of intraabdominal metastasis were compared. Results: Forty patients successfully completed laparoscopy with collection of peritoneal washings. Laparoscopic examination of the peritoneal cavity upstaged 21 (52.5%) patients. Laparoscopic examination consistently identified a statistically significant higher number of positive patients than cytologic examination of peritoneal washings (p = 0.001) and examination of cytologic washings alone failed to identify 45% of patients with positive findings and laparoscopy. The addition of cytologic examination added no additional stage IV patients to the laparoscopy-negative group. Conclusion: A standardized laparoscopic examination alone is sufficient for the identification of intraabdominal metastatic disease in patients with gastric and esophageal cancer.

Original languageEnglish (US)
Pages (from-to)852-856
Number of pages5
JournalSurgical Endoscopy and Other Interventional Techniques
Volume18
Issue number5
DOIs
StatePublished - May 2004

Keywords

  • Esophageal cancer
  • Gastric cancer
  • Peritoneal cytology
  • Staging laparoscopy

ASJC Scopus subject areas

  • Surgery

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