Staging laparoscopy in gastric cancer patients : From a Dutch nationwide Delphi consensus towards a standardized protocol
© 2024 Published by Elsevier Ltd..
BACKGROUND: Staging laparoscopy is a common diagnostic tool in gastric cancer, but its performance varies widely. The aim of this study was to gain Dutch nationwide consensus regarding the indications for and execution of staging laparoscopy in patients with gastric cancer.
METHODS: All surgeons in the Netherlands specialized in gastric cancer surgery (n = 52) were asked to participate in a Delphi consensus study. The study involved an initial questionnaire with a 3-point Likert scale, an online consensus meeting, and a second questionnaire using a 2-point Likert scale (agree/disagree). Consensus was defined as 70% or more agreement among participants.
RESULTS: In total, 45 experts completed both questionnaires (87% response rate). Consensus was reached on the indication to perform staging laparoscopy in cT3-4 or cN + or diffuse-type gastric cancer, including Siewert type III oesophagogastric junctional cancer. The experts agreed that if preoperative scans suggest infiltration of surrounding organs (cT4), the tumour's resectability should explicitly be investigated. Consensus was also reached for a systematic peritoneal cavity inspection according to Sugarbaker's Peritoneal Cancer Index (PCI) score. All regions should be inspected routinely, although the omental bursa may be inspected on indication. Aspiration of ascites or peritoneal washing should be performed for cytology. The experts agreed that restaging laparoscopy should be performed before resection in case of progressive disease on preoperative imaging. Without progression, global inspection was considered sufficient.
CONCLUSIONS: The results of this Dutch nationwide Delphi consensus study exposed the variability of performing staging laparoscopy in patients with gastric cancer and provided the concept for a standardized protocol.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology - 50(2024), 6 vom: 19. März, Seite 108278 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
van der Sluis, Karen [VerfasserIn] |
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| Links: |
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| Themen: |
Delphi study |
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| Anmerkungen: |
Date Revised 26.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.ejso.2024.108278 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370207866 |
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| 100 | 1 | |a van der Sluis, Karen |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Staging laparoscopy in gastric cancer patients |b From a Dutch nationwide Delphi consensus towards a standardized protocol |
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| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024 Published by Elsevier Ltd. | ||
| 520 | |a BACKGROUND: Staging laparoscopy is a common diagnostic tool in gastric cancer, but its performance varies widely. The aim of this study was to gain Dutch nationwide consensus regarding the indications for and execution of staging laparoscopy in patients with gastric cancer | ||
| 520 | |a METHODS: All surgeons in the Netherlands specialized in gastric cancer surgery (n = 52) were asked to participate in a Delphi consensus study. The study involved an initial questionnaire with a 3-point Likert scale, an online consensus meeting, and a second questionnaire using a 2-point Likert scale (agree/disagree). Consensus was defined as 70% or more agreement among participants | ||
| 520 | |a RESULTS: In total, 45 experts completed both questionnaires (87% response rate). Consensus was reached on the indication to perform staging laparoscopy in cT3-4 or cN + or diffuse-type gastric cancer, including Siewert type III oesophagogastric junctional cancer. The experts agreed that if preoperative scans suggest infiltration of surrounding organs (cT4), the tumour's resectability should explicitly be investigated. Consensus was also reached for a systematic peritoneal cavity inspection according to Sugarbaker's Peritoneal Cancer Index (PCI) score. All regions should be inspected routinely, although the omental bursa may be inspected on indication. Aspiration of ascites or peritoneal washing should be performed for cytology. The experts agreed that restaging laparoscopy should be performed before resection in case of progressive disease on preoperative imaging. Without progression, global inspection was considered sufficient | ||
| 520 | |a CONCLUSIONS: The results of this Dutch nationwide Delphi consensus study exposed the variability of performing staging laparoscopy in patients with gastric cancer and provided the concept for a standardized protocol | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Delphi study | |
| 650 | 4 | |a Gastric cancer | |
| 650 | 4 | |a Peritoneal cancer index | |
| 650 | 4 | |a Peritoneal metastases | |
| 650 | 4 | |a Staging laparoscopy | |
| 700 | 1 | |a Guchelaar, Niels A D |e verfasserin |4 aut | |
| 700 | 1 | |a Triemstra, Lianne |e verfasserin |4 aut | |
| 700 | 1 | |a Mathijssen, Ron H J |e verfasserin |4 aut | |
| 700 | 1 | |a Ruurda, Jelle P |e verfasserin |4 aut | |
| 700 | 1 | |a Wijnhoven, Bas P L |e verfasserin |4 aut | |
| 700 | 1 | |a van Sandick, Johanna W |e verfasserin |4 aut | |
| 700 | 0 | |a Collaborators |e verfasserin |4 aut | |
| 700 | 1 | |a van Berge Henegouwen, M I |e investigator |4 oth | |
| 700 | 1 | |a Gisbertz, S S |e investigator |4 oth | |
| 700 | 1 | |a Eshuis, W J |e investigator |4 oth | |
| 700 | 1 | |a Daams, F |e investigator |4 oth | |
| 700 | 1 | |a Borstlap, W A |e investigator |4 oth | |
| 700 | 1 | |a Luyer, M D P |e investigator |4 oth | |
| 700 | 1 | |a Simkens, G A |e investigator |4 oth | |
| 700 | 1 | |a Nieuwenhuizen, G A P |e investigator |4 oth | |
| 700 | 1 | |a van der Sluis, P C |e investigator |4 oth | |
| 700 | 1 | |a Lagarde, S M |e investigator |4 oth | |
| 700 | 1 | |a Noordman, B J |e investigator |4 oth | |
| 700 | 1 | |a Heisterkamp, J |e investigator |4 oth | |
| 700 | 1 | |a Matthijsen, R A |e investigator |4 oth | |
| 700 | 1 | |a Matthée, E P C |e investigator |4 oth | |
| 700 | 1 | |a Wassenaar, E B |e investigator |4 oth | |
| 700 | 1 | |a Pierik, E G J M |e investigator |4 oth | |
| 700 | 1 | |a Hartgrink, H H |e investigator |4 oth | |
| 700 | 1 | |a de Steur, W O |e investigator |4 oth | |
| 700 | 1 | |a Hutteman, M |e investigator |4 oth | |
| 700 | 1 | |a van der Harst, E |e investigator |4 oth | |
| 700 | 1 | |a Pierie, J E N |e investigator |4 oth | |
| 700 | 1 | |a Emous, M |e investigator |4 oth | |
| 700 | 1 | |a Kelder, W |e investigator |4 oth | |
| 700 | 1 | |a Hartemink, K J |e investigator |4 oth | |
| 700 | 1 | |a Veenhof, A A F A |e investigator |4 oth | |
| 700 | 1 | |a Hugen, N |e investigator |4 oth | |
| 700 | 1 | |a Klarenbeek, B R |e investigator |4 oth | |
| 700 | 1 | |a van Esser, S |e investigator |4 oth | |
| 700 | 1 | |a Bilgen, E J Spillenaar |e investigator |4 oth | |
| 700 | 1 | |a Witteman, B P L |e investigator |4 oth | |
| 700 | 1 | |a van Etten, B |e investigator |4 oth | |
| 700 | 1 | |a Dijkstra, F A |e investigator |4 oth | |
| 700 | 1 | |a Haveman, J W |e investigator |4 oth | |
| 700 | 1 | |a van der Bilt, A |e investigator |4 oth | |
| 700 | 1 | |a van Hillegersberg, R |e investigator |4 oth | |
| 700 | 1 | |a van den Berg, J W |e investigator |4 oth | |
| 700 | 1 | |a Brenkman, H J F |e investigator |4 oth | |
| 700 | 1 | |a Kouwenhoven, E A |e investigator |4 oth | |
| 700 | 1 | |a van Det, M J |e investigator |4 oth | |
| 700 | 1 | |a Stoot, J H M B |e investigator |4 oth | |
| 700 | 1 | |a Belgers, E H J |e investigator |4 oth | |
| 700 | 1 | |a Sosef, M N |e investigator |4 oth | |
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