In gastric cancer patients, determination of preoperative stage plays an important role in treatment.
The purpose of this sudy was to determine the accuracy of laparoscopic staging, through compared with clincal and pathologic stages.
Laparoscopic stage was stated by conventional laparoscopy and laparoscope assisted ult rasonography before laparotomy, clinical stage were stated by gastroscopy, upper G.I. series, ultrasonography, computerized tomography and serum tumor markers,
and
pathologic stage stated by histopathologic studies.
54 gastric cancer patients were enrolled in this study during 8 months from December 1993 to Jly 1994.
In tumor invasion, te overall accuracy of laparoscopic stage was 79%, clinical stage 57%. The staging accuracy of laparoscopic stage amounted to 85% in T1, 67%, clinical stage 57 %. The staging accuracy of laproscopic stage amounted to 85% in T1,
67% in
T1, 67% in T2, 71% in T3, 100% in T4, clinical stage 85% in T1, 33% in T2, 54% in T3, 40% in T4.
In lymph node metastasis, the overall accuracy of laparoscopic stage was 81%, clinical stage 52% The staging accuracy of laparoscopic stage amounted to 96% in N0, 67% in N1 72% in N2, clinical stage 87% in N0, 17% in N1, 28% in N2.
In intraabdominal distant metastasis, the overall accuracy of laparoscopic stage was 100%, clinical stage 70%. The staging accuracy of laproscopic stage amounted to 100% in M0 and M1, clinical stage 100% in M0, 20% in M1.
Throught this study. We had known that laparoscopic staging was more acurate diagnostic method than other clinical staging methods in determination of preoperative stage for stomach cancer.
Therefore laparoscopic stage might be a more reliable diagnostic method of preoperative stage for stomach cancer, it allows the surgeon to choose of initial treatment method, to select pttients for preoperative chemotherapy and to interpretate
the
therapeutic effect of induction chemotherapy.
|