STAGING LAPAROSCOPY IS STILL A VALUABLE TOOL FOR OPTIMAL GASTRIC CANCER MANAGEMENT

Complete surgical resection is the main determining factor in the survival of advanced gastric cancer patients, but is not indicated in metastatic disease. The peritoneum is a common site of metastasis and preoperative imaging techniques still fail to RESUMO -Racional: O tratamento de escolha para pacientes com hipertensao portal detect it. AI M: The aim of this study was to evaluate the role of staging laparoscopy in the esqustossomotica com sangramento de vriz e a desconexao azigo-portal mais staging of advanced gastric cancer patients in a Wes tern tertiary cancer center. METHODS: A total oesplenectomiaf 130 p atie(DAPE)nts with gassociadaastric aa denterapiocarcinmendoscopica.a who undPorem,erwe nt sestudostagin g lamostrmparos copyaumento from do calibre das varizes em alguns pacientes durante o seguimeto em lngo prazo. Objtivo: 2009 to 2020 were evaluated from a prospective database. Clinicopathological characteristics Avaliar o impacto da DAPE e tratamento endoscopico pos-operatorio no comportamento were analyzed to identify factors associated with the presence of peritoneal metastasis and were also evaluated the accuracy and strength of agreement between computed das varizes esofagicas e recidiva hemorragica, de pacientes esquistossomoticos. Metodos: tomography and staging laparoscopy in detecting peritoneal metastasis and the change in Form sudados 36 pacientes om seguimento superio a cinco anos, distribuios em treatment strategy after the procedure. RESULTS: The peritoneal metastasis was identified indois 6 6 (5grupos:0.76 %) quedapati edant s. Thpressaoe se nsiportaltivit y, sabaixopec ifideci ty,30% an ed acimacura cdey of30% co mputecomparadosd tom ogcomrap ho y calibre das varizes esofagicas no pos-operatorio precoce e tardio alem do indie e recidiva in detecting peritoneal metastasis were 51.5, 87.5, and 69.2%, respectively. According to the hemorragica. Resultados Kappa coefficient, the concordance between staging laparoscopy and computed tomography was 38.8%. In multivariate analysis, ascites (p=0.001) and suspected peritoneal metastasis on esofagicas que, durante o seguimento aumentaram de calibre e foram controladas com computed tomography (p=0.007) were statistically correlated with peritoneal metastasis. In 40 (30.8%) patients, staging and treatment plans changed after staging laparoscopy (32 patients oa vided ucomportamentonnecessa rydo l apacalibreroto mdasy, andvarizes 8 p atnoie nts, whopos-operatorio were p revioprecoceusly conemnsi detardioed stanemge IVos b indies de recidiva hemorragica. Conclusao by computed tomography, were referred to surgical treatment). CONCLUSION: The staging laparoscopy demonstrated an important role in the diagnosis of peritoneal metastasis, even with current advances in imaging techniques.