STAGING LAPAROSCOPY AND NEOADJUVANT CHEMOTHERAPY IN THE TREATMENT OF LOCALLY ADVANCED CANCER STOMACH: A PROSPECTIVE STUDY

Haris Bashir*, Iqbal Saleem Mir, Syed Naveed Ul Alam, Omar Mir, Mohammad Anyees Khanday and Arshad Rashid

ABSTRACT

Aim: To study the value of staging laparoscopy and neoadjuvant chemotherapy (NACT) in the treatment of locally advanced gastric cancer (LAGC). Methods: 32 Patients of radiologically proven locally advanced gastric cancer were enrolled for the study. All were subjected to staging laparoscopy, of whom 6 patients were excluded from the study after detecting occult metastasis. The patients were then subjected to 4 cycles of neoadjuvant chemotherapy and were then restaged radiologically, laparoscopically and pathologically. Results: Staging laparoscopy helped in averting unnecessary laparotomy in around 19% by detecting occult metastasis in them. No primary residual tumor (R0 resection rate) was found in 85%. Pathological complete response was seen in 15.38% of the cases and ypT0 -2 was seen in 61.53%, thereby showing significant downstaging post neoadjuvant chemotherapy (P-value= 0.005). Conclusion: Laparoscopy is an effective tool in staging of locally advanced cancer stomach, and Neoadjuvant chemotherapy proves of great significance in downstaging of the disease.

Keywords: Staging laparoscopy, Neoadjuvant chemotherapy, R0 resection, Pathological complete response.