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  • Title: Predicting factors of unexpected peritoneal seeding in locally advanced gastric cancer: indications for staging laparoscopy.
    Author: Hur H, Lee HH, Jung H, Song KY, Jeon HM, Park CH.
    Journal: J Surg Oncol; 2010 Dec 01; 102(7):753-7. PubMed ID: 20812349.
    Abstract:
    BACKGROUND AND OBJECTIVES: The aim of this study is to investigate predictive factors for unexpected peritoneal seeding from clinically resectable advanced gastric cancers to suggest the indications for staging laparoscopy (SL). METHODS: A total of consecutive 589 gastric cancer patients who were clinically diagnosed with advanced gastric cancer with no metastatic disease underwent operations at Seoul St. Mary's Hospital. RESULTS: A total of 72 patients (including 35 patients with seeding to distant peritoneum) were surgically diagnosed with peritoneal seeding. Borrmann type 3 (OR: 4.475) or type 4 (OR: 8.243) cancer, tumor invasion of T3 (OR: 2.794) or T4 (OR: 6.841) and tumor size (4  cm  ≤  tumor size  <  8  cm; OR: 3.723 and 8  cm  ≤  tumor size; OR: 6.971) were predictive factors for overall peritoneal seeding. Borrmann type 3 (OR: 3.524) or 4 (OR: 4.695) cancer, tumor invasion of T3 (OR: 4.378) or T4 (OR: 15.817), and tumors involving the anterior wall (OR: 2.762) also turned out to be predictive factors for distant peritoneal seeding. CONCLUSIONS: If SL were performed by these predictive factors, this should have been performed in 42.4% of advanced gastric cancers and the detection rates for overall peritoneal seeding would have been 24.0%.
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