The role of staging laparoscopy in treatment of locally advanced gastric cancer.

PURPOSE: The aim of this study was to evaluate the role of videolaparoscopy (VLP) in gastric cancer staging, particularly for the detection of peritoneal cancer, to verify its impact in changing the therapeutic conduct, as well as defining the characteristics of the group that can benefit from VLP as staging method.

PATIENTS AND METHODS: A prospective cohort study was conducted from May 2011 to March 2013. Thirty-two patients with gastric adenocarcinoma underwent conventional staging together with VLP staging.

RESULTS: VLP identified peritoneal disease in 22.6% of patients. Sensitivity was 86%, and specificity was 100%. In the group with non-Borrmann IV, <8 cm tumors, and without evidence of lymphadenomegaly, VLP identified peritoneal implants in 23.1% of cases.

CONCLUSIONS: VLP is a safe procedure capable of improving the accuracy of gastric cancer staging. There is no justification for failing to perform laparoscopy in patients with <8 cm, non-Borrmann type IV tumors and without evidence of lymphadenomegaly on preoperative examinations.