201: THE YIELD OF DIAGNOSTIC LAPAROSCOPY WITH PERITONEAL LAVAGE IN GASTRIC ADENOCARCINOMA: A MULTICENTRE RETROSPECTIVE COHORT STUDY

Abstract

Abstract Background and aim Diagnostic laparoscopy (DL) with peritoneal lavage has been adopted as a standard staging procedure for patients with gastric cancer. Evaluating the effectiveness of DL is important given the ongoing improvement of diagnostic imaging. Studies on DL from Europe are scarce and mostly include a small number of patients. This multicentre retrospective cohort study assessed the yield of DL in patients with potentially curable gastric cancer. Methods Patients with adenocarcinoma of the stomach treated between January 2016 and December 2018 were identified from an institutional database from two high volume European Upper-GI surgical centres. Patients who underwent a diagnostic laparoscopy with peritoneal lavage for potentially curable disease after clinical staging with imaging (stage cT1-4 N0-3 M0) were included. Results Overall, in 78 of 327 included patients (23.8%) metastatic disease was diagnosed. Macroscopic metastases were seen in 32 of 327 (9.8%) patients, of which 26 were peritoneal lesions. Sixteen of these also had positive peritoneal cytology. A further 41 of 327 patients (12.5%) had positive peritoneal cytology in the absence of macroscopic metastases and five patients (1.5%) were deemed to have locally irresectable disease. Only one of the eighteen patients (6%) staged cT1–2 N0 had positive cytology and three of seven patients (43%) with stage cT1–2 N+ had macroscopic metastases. Conclusion Diagnostic laparoscopy should routinely be performed in all patients with gastric cancer including patients with cT1–2 disease.