The Diagnostic Accuracy of Multi-detector Ct Versus Staging Laparoscopy in Oesophagogastric Cancer Peritoneal Metastases

Matthew F Leeman, MBChB MSc MRCS, Patel Dilip, FRCR, Anderson Judith, FRCR, Simon Paterson-brown, MBBS MPhil MS FRCSEd FRCSEng. Department of Surgery, Royal Infirmary of Edinburgh, UK


Introduction: Accurate staging before potentially curative resection is essential in patients with oesophagogastric (OG) cancer. Staging Laparoscopy (SL) is the current gold standard investigation for detecting peritoneal metastases (PM) but Computed Tomography (CT) technology is undergoing rapid improvements. The aim of this study was to investigate whether multi-detector CT can replace SL.
Methods and Procedures: The operation notes of SL performed in Edinburgh between January 2008 and December 2009 were reviewed for the detection of PM. Corresponding CT scans were re-assessed by two experienced gastrointestinal radiologists. Results were compared with findings at subsequent resection or biopsies with histological confirmation of PM.
Results: 63 SL were included in the study. The sensitivity and specificity of SL for PM were 90% (95% CI 54.1-99.5) and 100% (90.4-100). CT review by radiologist 1 yielded sensitivity and specificity of 30% (8.1-64.6) and 91.3% (78.3-97.2). For radiologist 2 the sensitivity and specificity were 66.7% (30.9-91.0) and 88.9% (75.2-95.8). Cross-tabulation yielded substantial agreement (Kappa 0.663).
Conclusion: SL remains the gold standard staging investigation for PM in OG cancer. At present CT cannot replace SL for the detection of PM in OG cancer staging.

Session Number: Poster – Poster Presentations
Program Number: P204
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