PROSPECTIVE COMPARISON OF LAPAROSCOPY, ULTRASONOGRAPHY AND COMPUTED-TOMOGRAPHY IN THE STAGING OF GASTRIC-CANCER

A total of 103 consecutive patients with gastric adenocarcinoma was as sessed for intra-abdominal spread of malignancy using ultrasonography, computed tomography (CT) and laparoscopy under general anaesthesia. H istologically proven metastases were to the liver in 27 patients, lymp h nodes in 49 and directly to peritoneum in 13. All modalities showed a high specificity (92-100 per cent) for each type of metastasis. Lapa roscopy was more sensitive in detecting hepatic, nodal and peritoneal metastases; the relative performance of laparoscopy was best with rega rd to hepatic metastases. Ultrasonography and CT were particularly poo r at detecting nodal and peritoneal metastases. There was no significa nt morbidity and no mortality associated with laparoscopy, which was m ore accurate in preoperative staging of gastric cancer than ultrasonog raphy or CT.