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Feasibility and accuracy of second-look laparoscopy after gastrectomy for gastric cancer

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Abstract

Background

A better method for detecting early peritoneal progression is needed. This study evaluated the feasibility and accuracy of second-look laparoscopy for patients with gastric cancer treated using systemic chemotherapy after gastrectomy.

Methods

Second-look laparoscopy was conducted for patients who had no clinical evidence of distant metastases but had peritoneal metastases or positive peritoneal cytology results without visible metastatic disease at initial surgery, patients who underwent systemic chemotherapy over a 6-month period after surgery, and patients who had no clinical evidence of disease based on imaging study after completion of primary chemotherapy.

Results

Between November 2004 and April 2008, 21 patients underwent second-look laparoscopy. At the initial surgery, 13 of these patients underwent total gastrectomy and 8 patients underwent distal gastrectomy. One or two sheets of adhesion barrier were received by 18 patients. The median interval between initial surgery and second-look laparoscopy was 9.8 months (range, 6.6–17.5 months). All second-look procedures were completed laparoscopically, and no patients required conversion to laparotomy. None of the 21 patients experienced postlaparoscopy complications. Whereas 12 patients showed no pathologic evidence of disease, 9 patients showed disease at second-look laparoscopy. There was a significant difference in median survival between the groups with negative and positive results (p = 0.017). The median survival for the negative group has not been determined. All the patients in the positive group received further chemotherapy while showing a good performance status (PS). Six patients were PS 0, and 3 patients were PS 1. The median survival time for this group was 10.1 months.

Conclusions

Second-look laparoscopy was a safe and promising approach to reassessment of peritoneal disease for patients with gastric cancer. The incidence of complications was low, particularly in this group of patients, all of whom had undergone prior gastrectomy.

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References

  1. Parkin DM, Bray FI, Devesa SS (2001) Cancer burden in the year 2000: the global picture. Eur J Cancer 37(Suppl 8):S4–S66

    Article  PubMed  Google Scholar 

  2. Inoue K, Nakane Y, Michiura T, Nakai K, Sato M, Okumura S, Yamamichi K, Okamura S, Imabayashi N (2004) Trends in long-term survival following surgery for gastric cancer: a single-institution experience. Oncol Rep 11:459–464

    PubMed  Google Scholar 

  3. Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, Haller DG, Ajani JA, Gunderson LL, Jessup JM, Martenson JA (2001) Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 345:725–730

    Article  CAS  PubMed  Google Scholar 

  4. Nakajima T, Nishi M, Kajitani T (1991) Improvement in treatment results of gastric cancer with surgery and chemotherapy: experience of 9,700 cases in the Cancer Institute Hospital, Tokyo. Semin Surg Oncol 7:365–372

    Article  CAS  PubMed  Google Scholar 

  5. Msika S, Tazi MA, Benhamiche AM, Couillault C, Harb M, Faivre J (1997) Population-based study of diagnosis, treatment and prognosis of gastric cancer. Br J Surg 84:1474–1478

    Article  CAS  PubMed  Google Scholar 

  6. Maehara Y, Hasuda S, Koga T, Tokunaga E, Kakeji Y, Sugimachi K (2000) Postoperative outcome and sites of recurrence in patients following curative resection of gastric cancer. Br J Surg 87:353–357

    Article  CAS  PubMed  Google Scholar 

  7. Yoo CH, Noh SH, Shin DW, Choi SH, Min JS (2000) Recurrence following curative resection for gastric carcinoma. Br J Surg 87:236–242

    Article  CAS  PubMed  Google Scholar 

  8. Oh SY, Kwon HC, Lee S, Lee DM, Yoo HS, Kim SH, Jang JS, Kim MC, Jeong JS, Kim HJ (2007) A phase II study of oxaliplatin with low-dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFOX-4) for gastric cancer patients with malignant ascites. Jpn J Clin Oncol 37:930–935

    Article  PubMed  Google Scholar 

  9. Chau I, Norman AR, Cunningham D, Waters JS, Oates J, Ross PJ (2004) Multivariate prognostic factor analysis in locally advanced and metastatic esophago-gastric cancer-pooled analysis from three multicenter, randomized, controlled trials using individual patient data. J Clin Oncol 22:2395–2403

    Article  PubMed  Google Scholar 

  10. Sarela AI, Miner TJ, Karpeh MS, Coit DG, Jaques DP, Brennan MF (2006) Clinical outcomes with laparoscopic stage M1, unresected gastric adenocarcinoma. Ann Surg 243:189–195

    Article  PubMed  Google Scholar 

  11. Ajani JA, Mansfield PF, Lynch PM, Pisters PW, Feig B, Dumas P, Evans DB, Raijman I, Hargraves K, Curley S, Ota DM (1999) Enhanced staging and all chemotherapy preoperatively in patients with potentially resectable gastric carcinoma. J Clin Oncol 17:2403–2411

    CAS  PubMed  Google Scholar 

  12. Littell RD, Hallonquist H, Matulonis U, Seiden MV, Berkowitz RS, Duska LR (2006) Negative laparoscopy is highly predictive of negative second-look laparotomy following chemotherapy for ovarian, tubal, and primary peritoneal carcinoma. Gynecol Oncol 103:570–574, Epub 2006 June 12

    Article  PubMed  Google Scholar 

  13. Husain A, Chi DS, Prasad M, Abu-Rustum N, Barakat RR, Brown CL, Poynor EA, Hoskins WJ, Curtin JP (2001) The role of laparoscopy in second-look evaluations for ovarian cancer. Gynecol Oncol 80:44–47

    Article  CAS  PubMed  Google Scholar 

  14. Clough KB, Ladonne JM, Nos C, Renolleau C, Validire P, Durand JC (1999) Second-look for ovarian cancer: laparoscopy or Laparotomy? A prospective comparative study. Gynecol Oncol 72:411–417

    Article  CAS  PubMed  Google Scholar 

  15. Rosenoff SH, Young RC, Anderson T, Bagley C, Chabner B, Schein PS, Hubbard S, DeVita VT (1975) Peritoneoscopy: a valuable staging tool in ovarian carcinoma. Ann Intern Med 83:37–41

    CAS  PubMed  Google Scholar 

  16. Quinn MA, Bishop GJ, Campbell JJ, Rodgerson J, Pepperell RJ (1980) Laparoscopic follow-up of patients with ovarian carcinoma. Br J Obstet Gynaecol 87:1132–1139

    CAS  PubMed  Google Scholar 

  17. Ozols RF, Fisher RI, Anderson T, Makuch R, Young RC (1981) Peritoneoscopy in the management of ovarian cancer. Am J Obstet Gynecol 140:611–619

    CAS  PubMed  Google Scholar 

  18. Berek JS, Hacker NF (1983) Laparoscopy in the management of patients with ovarian carcinoma. Clin Obstet Gynaecol 10:213–222

    CAS  PubMed  Google Scholar 

  19. Gadducci A, Sartori E, Maggino T, Zola P, Landoni F, Fanucchi A, Palai N, Alessi C, Ferrero AM, Cosio S, Cristofani R (1998) Analysis of failures after negative second-look in patients with advanced ovarian cancer: an Italian multicenter study. Gynecol Oncol 68:150–155

    Article  CAS  PubMed  Google Scholar 

  20. Japanese Gastric Cancer Association (1995) Japanese classification of gastric carcinoma. 1st English edn. Kanehara & Co. Ltd., Tokyo

  21. Casey AC, Farias-Eisner R, Pisani AL, Cirisano FD, Kim YB, Muderspach L, Futoran R, Leuchter RS, Lagasse LD, Karlan BY (1996) What is the role of reassessment laparoscopy in the management of gynecologic cancers in 1995? Gynecol Oncol 60:454–461

    Article  CAS  PubMed  Google Scholar 

  22. Abu-Rustum NR, Barakat RR, Siegel PL, Venkatraman E, Curtin JP, Hoskins WJ (1996) Second-look operation for epithelial ovarian cancer: laparoscopy or laparotomy? Obstet Gynecol 88(4 Pt 1):549–553

    Article  CAS  PubMed  Google Scholar 

  23. Smith WG, Day TG Jr, Smith JP (1977) The use of laparoscopy to determine the results of chemotherapy for ovarian cancer. J Reprod Med 18:257–260

    CAS  PubMed  Google Scholar 

  24. Vrijland WW, Tseng LN, Eijkman HJ, Hop WC, Jakimowicz JJ, Leguit P, Stassen LP, Swank DJ, Haverlag R, Bonjer HJ, Jeekel H (2002) Fewer intraperitoneal adhesions with use of hyaluronic acid-carboxymethylcellulose membrane: a randomized clinical trial. Ann Surg 235:193–199

    Article  PubMed  Google Scholar 

  25. Fazio VW, Cohen Z, Fleshman JW, van Goor H, Bauer JJ, Wolff BG, Corman M, Beart RW Jr, Wexner SD, Becker JM, Monson JR, Kaufman HS, Beck DE, Bailey HR, Ludwig KA, Stamos MJ, Darzi A, Bleday R, Dorazio R, Madoff RD, Smith LE, Gearhart S, Lillemoe K, Göhl J (2006) Reduction in adhesive small-bowel obstruction by Seprafilm adhesion barrier after intestinal resection. Dis Colon Rectum 49:1–11

    Article  PubMed  Google Scholar 

  26. Hamaguchi T, Shirao K, Yamamichi N, Hyodo I, Koizumi W, Seki S, Imamura T, Honma H, Ohtsu A, Boku N, Mukai T, Yamamoto S, Fukuda H, Yoshida S, Gastrointestinal Oncology Study Group of Japan Clinical Oncology Group (2008) A phase II study of sequential methotrexate and 5-fluorouracil chemotherapy in previously treated gastric cancer: a report from the Gastrointestinal Oncology Group of the Japan Clinical Oncology Group, JCOG 9207 trial. Jpn J Clin Oncol 38:432–437, Epub 2008 May 30

    Article  PubMed  Google Scholar 

  27. Jeong J, Jeung HC, Rha SY, Im CK, Shin SJ, Ahn JB, Noh SH, Roh JK, Chung HC (2008) Phase II study of combination chemotherapy of 5-fluorouracil, low-dose leucovorin, and oxaliplatin (FLOX regimen) in pretreated advanced gastric cancer. Ann Oncol 19:1135–1140, Epub 2008 Feb 13

    Article  CAS  PubMed  Google Scholar 

  28. Rosati G, Bilancia D, Germano D, Dinota A, Romano R, Reggiardo G, Manzione L (2007) Reduced-dose intensity of docetaxel plus capecitabine as second-line palliative chemotherapy in patients with metastatic gastric cancer: a phase II study. Ann Oncol 18(Suppl 6):vi128–vi132

    Article  PubMed  Google Scholar 

  29. Jeung HC, Rha SY, Shin SJ, Ahn JB, Noh SH, Roh JK, Chung HC (2007) A phase II study of S-1 monotherapy administered for 2 weeks of a 3-week cycle in advanced gastric cancer patients with poor performance status. Br J Cancer 97:458–463, Epub 2007 Jul 24

    Article  CAS  PubMed  Google Scholar 

  30. Lee JL, Ryu MH, Chang HM, Kim TW, Yook JH, Oh ST, Kim BS, Kim M, Chun YJ, Lee JS, Kang YK (2008) A phase II study of docetaxel as salvage chemotherapy in advanced gastric cancer after failure of fluoropyrimidine and platinum combination chemotherapy. Cancer Chemother Pharmacol 61:631–637, Epub 2007 May 23

    Article  CAS  PubMed  Google Scholar 

  31. Shin SJ, Jeung HC, Ahn JB, Choi HJ, Cho BC, Rha SY, Yoo NC, Roh JK, Chung HC (2008) Capecitabine and doxorubicin combination chemotherapy as salvage therapy in pretreated advanced gastric cancer. Cancer Chemother Pharmacol 61:157–165, Epub 2007 Apr 11

    Article  CAS  PubMed  Google Scholar 

  32. Takiuchi H, Goto M, Imamura H, Furukawa H, Imano M, Imamoto H, Kimura Y, Ishida H, Fujitani K, Narahara H, Shimokawa T (2008) Multicenter phase II study for combination therapy with paclitaxel/doxifluridine to treat advanced/recurrent gastric cancer showing resistance to S-1 (OGSG 0302). Jpn J Clin Oncol 38:176–181

    Article  PubMed  Google Scholar 

  33. Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamura Y, Yanaoka K, Orita H, Takeuchi M (2008) S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 9:215–221

    Article  CAS  PubMed  Google Scholar 

  34. Briasoulis E, Fatouros M, Roukos DH (2007) Level I evidence in support of perioperative chemotherapy for operable gastric cancer: sufficient for wide clinical use? Ann Surg Oncol 14:2691–2695

    Article  PubMed  Google Scholar 

  35. Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, Furukawa H, Nakajima T, Ohashi Y, Imamura H, Higashino M, Yamamura Y, Kurita A, Arai K, Group ACTS-GC (2007) Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 357:1810–1820

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Kansai Medical University, 2-3-1 Sinmachi, Hirakata, Osaka, 573-1191, Japan

    Kentaro Inoue, Yasushi Nakane, Taku Michiura, Sou Yamaki, Rintaro Yui, Kazuhito Sakuramoto, Aiko Iwai, Katsuji Tokuhara, Yoshiro Araki, Songtae Kim, Koji Nakai, Mutsuya Sato, Keigo Yamamichi & A-Hon Kwon

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  1. Kentaro Inoue
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  2. Yasushi Nakane
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Correspondence to Kentaro Inoue.

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Inoue, K., Nakane, Y., Michiura, T. et al. Feasibility and accuracy of second-look laparoscopy after gastrectomy for gastric cancer. Surg Endosc 23, 2307–2313 (2009). https://doi.org/10.1007/s00464-008-0324-z

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  • DOI: https://doi.org/10.1007/s00464-008-0324-z

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