ThTP2.3 Value of staging laparoscopy in patients with oesophageal and junctional cancers – Single centre retrospective observational study

Abstract

Abstract Introduction The role of staging laparoscopy in oesophageal and junctional cancer remains controversial due to lack of robust evidence leading to heterogenous practice nationally and globally. The purpose of this study was to identify the value of staging laparoscopy in patients with oesophageal and junctional cancer. Methods A retrospective review of all consecutive patients who underwent staging laparoscopy for oesophageal and junctional cancer over 7-year period at Royal Derby Hospital, Derby was conducted using hospital database. Patient demographics, histology, staging, location, and findings of staging laparoscopy were analysed. Results A total of 278 of patients underwent staging laparoscopy from July 2015 to September 2022 were included. All patients with gastric cancer histology were excluded. Majority of the patients were having adenocarcinoma histology (N=248, 89.2%) and 236 (84.8%) cancers were involving lower oesophagus/ GOJ. Additionally, nearly three-quarters of patients (N=203, 73%) were having T3 staging before the procedure. Overall, staging laparoscopy had changed the management in 22 patients (7.9%) due to positive cytology (N=12, 4.3%) and other findings (N=10, 3.5%) such as cirrhosis liver, large bulky tumour, and peritoneal deposits. Out of patients who were having positive cytology, all had adenocarcinoma histology, located in the lower oesophagus, and had T3 or above pre-operative staging. Conclusion This study identified the value of staging laparoscopy in patients with certain risk factors who are at risk of having peritoneal disease. Therefore, selective approach would be more appropriate when selecting patients for staging laparoscopy in oesophageal and junctional cancer.