Exploratory laparotomy in the detection of abdominal metastases of primary lung cancer

From January 1974 to December 1976 122 exploratory laparotomies were performed in patients with primary lung cancer. With this method detection of asymptomatic abdominal metastases was achieved in 23.8% of the cases. The more frequent sites of metastases were the abdominal lymph nodes and the liver. The most common histological findings were oat-cell carcinoma (50%) and adenocarcinoma (35.7%). The detection of asymptomatic abdominal metastases using this procedure permitted the modification of the clinical staging (adopted by the UICC) in 9.8% of the cases, with emphasis on clinical stage I and II. This diagnostic procedure is harmless: no patient died during the period of the study. The authors recommended inclusion of exploratory laparotomy as an adequate routine means both for the detection of abdominal metastases and for the surgical and clinical staging of primary lung cancer, with emphasis on female patients and clinical stages I and II.