Abstract：
BACKGROUND: Since 2016, staging laparoscopy has been implemented in the diagnostic workup of patients with gastric cancer. Staging laparoscopy aims to detect incurable disease (peritoneal metastases and irresectable tumors) and to prevent futile laparotomies.
METHODS: In this population-based nationwide study, we sought patient- and tumor characteristics associated with undergoing a staging laparoscopy. Additionally, we analyzed the prevalence of synchronous peritoneal metastases, the outcome of the staging laparoscopy and its clinical impact on treatment decisions. All patients diagnosed with non-cardia gastric cancer from the Netherlands Cancer Registry between 2016 and 2021 were included.
RESULTS: Alongside tumor characteristics, patient characteristics such as younger age, absence of comorbidities and lower WHO performance status were associated with performing a staging laparoscopy. In the study period, an increase in the proportion of patients who underwent a staging laparoscopy was observed, from 19.6% in 2016 to 32.3% in 2021 (p-value<0.001). In the same period, the prevalence of synchronous peritoneal metastases increased from 25% to 31%. In 37.6% of the patients who had the outcome of their staging laparoscopy reported, had incurable disease diagnosed during staging laparoscopy. Significantly less of these patients were treated with triplet regimens as compared to patients with a negative staging laparoscopy (18.5 vs. 76.3%; p-value<0.001).
CONCLUSIONS: The implementation of staging laparoscopy in gastric cancer patients paralleled the increase in diagnosis of incurable disease and a decrease in the application of triplet systemic therapies in these patients.
METHODS: In this population-based nationwide study, we sought patient- and tumor characteristics associated with undergoing a staging laparoscopy. Additionally, we analyzed the prevalence of synchronous peritoneal metastases, the outcome of the staging laparoscopy and its clinical impact on treatment decisions. All patients diagnosed with non-cardia gastric cancer from the Netherlands Cancer Registry between 2016 and 2021 were included.
RESULTS: Alongside tumor characteristics, patient characteristics such as younger age, absence of comorbidities and lower WHO performance status were associated with performing a staging laparoscopy. In the study period, an increase in the proportion of patients who underwent a staging laparoscopy was observed, from 19.6% in 2016 to 32.3% in 2021 (p-value<0.001). In the same period, the prevalence of synchronous peritoneal metastases increased from 25% to 31%. In 37.6% of the patients who had the outcome of their staging laparoscopy reported, had incurable disease diagnosed during staging laparoscopy. Significantly less of these patients were treated with triplet regimens as compared to patients with a negative staging laparoscopy (18.5 vs. 76.3%; p-value<0.001).
CONCLUSIONS: The implementation of staging laparoscopy in gastric cancer patients paralleled the increase in diagnosis of incurable disease and a decrease in the application of triplet systemic therapies in these patients.
摘要：
背景：自2016年以来，分期腹腔镜已在胃癌患者的诊断检查中实施。分期腹腔镜检查旨在检测无法治愈的疾病（腹膜转移和无法切除的肿瘤）并防止徒劳的腹腔镜手术。
方法：在这项基于人群的全国性研究中，我们寻找与进行分期腹腔镜检查相关的患者和肿瘤特征.此外,我们分析了同时性腹膜转移的患病率，分期腹腔镜检查的结果及其对治疗决策的临床影响。纳入了2016年至2021年荷兰癌症登记处诊断为非贲门胃癌的所有患者。
结果：除了肿瘤特征，患者特征，如年龄较小，没有合并症和较低的WHO表现状态与进行分期腹腔镜检查相关.在学习期间,观察到接受分期腹腔镜检查的患者比例增加，从2016年的19.6%到2021年的32.3%（p值<0.001）。在同一时期,同步腹膜转移的患病率从25%增加到31%.在37.6％的患者谁有他们的分期腹腔镜结果报告，在分期腹腔镜检查期间诊断出不治之症。与分期腹腔镜检查阴性的患者相比，接受三联疗法治疗的患者明显少（18.5vs.76.3%；p值<0.001）。
结论：在胃癌患者中实施分期腹腔镜检查与不治之症的诊断增加和在这些患者中应用三联疗法的减少平行。
方法：在这项基于人群的全国性研究中，我们寻找与进行分期腹腔镜检查相关的患者和肿瘤特征.此外,我们分析了同时性腹膜转移的患病率，分期腹腔镜检查的结果及其对治疗决策的临床影响。纳入了2016年至2021年荷兰癌症登记处诊断为非贲门胃癌的所有患者。
结果：除了肿瘤特征，患者特征，如年龄较小，没有合并症和较低的WHO表现状态与进行分期腹腔镜检查相关.在学习期间,观察到接受分期腹腔镜检查的患者比例增加，从2016年的19.6%到2021年的32.3%（p值<0.001）。在同一时期,同步腹膜转移的患病率从25%增加到31%.在37.6％的患者谁有他们的分期腹腔镜结果报告，在分期腹腔镜检查期间诊断出不治之症。与分期腹腔镜检查阴性的患者相比，接受三联疗法治疗的患者明显少（18.5vs.76.3%；p值<0.001）。
结论：在胃癌患者中实施分期腹腔镜检查与不治之症的诊断增加和在这些患者中应用三联疗法的减少平行。
