The role of diagnostic laparoscopy in staging distal esophageal adenocarcinoma

Objectives: The study objectives were to determine whether diagnostic laparoscopy improves staging accuracy in selected patients with distal esophageal adenocarcinoma and to identify clinicopathologic features associated with positive diagnostic laparoscopy. Methods: Patients with distal esophageal adenocarcinoma who underwent diagnostic laparoscopy from 2000 to 2023 at a single institution were identified from a prospectively maintained surgical database. Exclusion criteria included performance of diagnostic laparoscopy after systemic therapy, absence of staging positron computed tomography/computed tomography, and M1 disease before diagnostic laparoscopy. Fisher exact test and Wilcoxon rank-sum test were used to compare categorical and continuous variables, respectively, between patients with negative and positive diagnostic laparoscopy. Clinicopathologic features were assessed using multivariable logistic regression. Results: .341) were not associated with positive diagnostic laparoscopy. Conclusions: Signet ring feature is associated with peritoneal disease. The use of diagnostic laparoscopy in these patients may lead to better staging and more appropriate treatment strategies.