Staging laparoscopy for locally advanced gastric cancer in Chinese patients: a multicenter prospective registry study

Ziyu Li,Gang Xiao,Lianhai Zhang,Zhemin Li,Fei Li,Jiafu Ji,Qian Liu,Zhenjun Wang,Shibin Wang,Jianchun Yu,Wei Fu,Xin Wang,Lin Chen,Yingjiang Ye,Zhongtao Zhang

doi:10.1186/s12885-017-3791-6

Abstract

BackgroundStaging laparoscopy(SL) is a recommended technique for the staging of Gastric Cancer(GC) and provides the indication for a radical surgery. Considering the medical practice in China, the standardized and regular usage of SL is yet to be spread. However, existing guidelines vary and make an ambiguity of indication for SL. Besides, the specific indication for Chinese patients remains a niche. This study aims to the essential, missing information of Chinese patients and tries to normalize the indication of LS in medical practice in China.MethodsThe study is a prospective, multicenter cohort study being conducted in China with a total of 450 patients, all diagnosed with locally advanced gastric cancer (cT2-4 N0-3 M0, no evidence of intra-abdominal dissemination) through Computed Tomography(CT) and/or Endoscopic Ultrasonography(EUS). Peritoneal lavage is regularly performed during the SL. Multivariate Cox regression model and receiver-operator characteristic(ROC) analysis will be used to analyze the significant risk factors of intra-abdominal metastasis(including peritoneal dissemination and a positive cytological result).DiscussionThis confirmatory study will provide us with the specific positive rate of intraabdominal metastasis of GC in China, compared with empirical evidence of 20%. We expect this trial will contribute to our discovery of the specific risk factors of intra-abdominal metastasis of Chinese patients and to the stimulating and performing of minimally invasive surgical procedures.Trial registrationClinicalTrials.gov: registration number NCT02172690.

Highlights

Staging laparoscopy(SL) is a recommended technique for the staging of Gastric Cancer(GC) and provides the indication for a radical surgery
Precise staging is a foremost method that benefits the successful surgical intervention of cancer, contributed to the improvement of medical tools: despite the fact that preoperative imaging techniques have significantly improved the diagnostic accuracy of wall infiltration and lymph node involvement, the detection of peritoneal dissemination still needs to be developed; positive intraperitoneal findings of free cancer cells has been proved to be related with poor survival yet could only be confirmed during surgical procedure [2, 3]
The aim of this study is to acquire a basic data on the positive rate of SL in Chinese patients and to identify the risk factors associated with intra-abdominal metastasis

Summary

Introduction

Staging laparoscopy(SL) is a recommended technique for the staging of Gastric Cancer(GC) and provides the indication for a radical surgery. The specific indication for Chinese patients remains a niche. This study aims to the essential, missing information of Chinese patients and tries to normalize the indication of LS in medical practice in China. Precise staging is a foremost method that benefits the successful surgical intervention of cancer, contributed to the improvement of medical tools: despite the fact that preoperative imaging techniques have significantly improved the diagnostic accuracy of wall infiltration and lymph node involvement, the detection of peritoneal dissemination still needs to be developed; positive intraperitoneal findings of free cancer cells has been proved to be related with poor survival yet could only be confirmed during surgical procedure [2, 3]. No specific recommended indications for Chinese patients can be referred to for lack of solid evidence

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