Impiego Combinato della Laparoscopia e Della Biopsia Ossea Nella Determinazione Dello Stadio Del Carcinoma Indifferenziato a Piccole Cellule del Polmone. Valutazione di 116 Casi Consecutivi

Abstract

116 consecutive patients with small cell anaplastic carcinoma of the lung had laparoscopy with multiple liver biopsies and bone marrow biopsy, performed as a staging procedure. Bone marrow biopsy was positive in 13 patients (11.2 %); no significant rise in percent was seen when bilateral specimens were obtained. Laparoscopy was positive in 17 patients (14.6 %); one patient had extrahepatic involvement only. Liver scan did not show high correlation with laparoscopy: 6 patients out of 11 had negative liver scan with metastases demonstrated at laparoscopy. Only 6 patients had laparoscopy positive along with bone marrow biopsy (5.1 %). At determination of the stage, 12 patients out of 78 (15.3 %), with apparently localized disease had diffuse disease after the two procedures. Laparoscopy and bone marrow biopsy were positive in 12 patients out of 38 (31.5 %), when the disease was diffuse at diagnosis. 7 patients had liver metastases at diagnosis, which were excluded after laparoscopy. Laparoscopy and bone marrow remain valuable procedures in assessing stage in small cell anaplastic carcinoma of the lung, because of their high rate of stage modifications due to their combined employment at diagnosis.