Meta-Analysis of Staging Laparoscopy Versus Computed Tomography in Oesophagogastric Cancer Staging

Matthew F Leeman, MBChB MSc MRCS. Department of Surgery, Royal Infirmary of Edinburgh, UK


Introduction: Accurate staging before potentially curative resection is essential in patients with oesophagogastric (OG) cancer. The aim of this study was to review the evidence for Staging Laparoscopy (SL) and Computed Tomography (CT) in OG cancer, with particular reference to peritoneal metastases (PM).
Methods and Procedures: Medline, EMBASE and the Cochrane library were searched for relevant studies and the results reviewed systematically. Pooled sensitivity, specificity and area under curve (AUC) for receiver operating characteristic curves were calculated.
Results: 133 studies were reviewed and 43 studies were accepted for meta-analysis. Random-effects pooled sensitivity and specificity of SL for overall resectability were 77.1% (95% CI 74.8-79.2) and 99.9% (99.6-1.00); for CT, sensitivity and specificity were 39.7% (28.5-51.9) and 97.2% (92.2-99.4). Resectability AUC of SL and CT were 0.9843 (Standard error 0.0029) and 0.8614 (0.0592), respectively. For PM detection, the sensitivity and specificity were 86.5% (82.0-90.2) and 98.5% (97.5-99.2) for SL and 29.1% (19.8-39.9) and 100% (98.4-100) for CT. AUC of SL and CT for PM were 0.9815 (0.0066) and 0.9257 (0.0391), respectively.
Conclusion: SL is an important tool in confirming the resectability of OG cancer, particularly with respect to the detection of PM.

Session Number: Poster – Poster Presentations
Program Number: P203
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