Staging Techniques in Gastric Cancer Evaluation
Summary
Accurate staging of gastric cancer is pivotal to tailoring treatment and avoiding futile interventions. The initial work-up customarily includes endoscopic inspection with biopsy and cross-sectional imaging, notably contrast-enhanced computed tomography, to assess local invasion, nodal involvement and distant spread. Endoscopic ultrasound can refine assessment of tumour depth and regional lymph nodes. Functional imaging with fluorodeoxyglucose positron emission tomography combined with CT (FDG-PET/CT) adds sensitivity for distant metastases but may miss peritoneal disease. Staging laparoscopy, often with peritoneal lavage cytology, remains the gold standard for detecting occult peritoneal metastases, thereby preventing unnecessary laparotomy and informing decision-making on neoadjuvant therapy. Emerging approaches integrate computer-assisted image analysis and molecular biomarkers into conventional staging pathways. Harmonisation of protocols—whether systematic laparoscopic exploration or standardised imaging sequences—has improved diagnostic yield. Recent efforts focus on combining radiological, endoscopic and laparoscopic data with artificial intelligence to deliver personalised risk stratification and guide surgical and systemic therapy on a global scale.
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Staging Techniques in Gastric Cancer Evaluation publication trend
The graph below shows the total number of articles in staging techniques in gastric cancer evaluation across all publications each year (not limited to Nature Index journals).
Technical terms
Staging laparoscopy: A minimally invasive surgical procedure to inspect the abdominal cavity for occult metastases and obtain peritoneal cytology samples.
Peritoneal cytology: Microscopic examination of peritoneal fluid to detect free cancer cells indicative of peritoneal dissemination.
FDG-PET/CT: Hybrid imaging modality combining positron emission tomography using fluorodeoxyglucose with CT to identify metabolically active malignant lesions.
Endoscopic ultrasound (EUS): A technique that uses high-frequency ultrasound via an endoscope to evaluate tumour depth and regional lymph node status.
References
- The Role of Staging Laparoscopy for Gastric Cancer Patients: Current Evidence and Future Perspectives. Cancers (2023).
- Role of staging laparoscopy for gastric cancer patients. Annals of Gastroenterological Surgery (2019).
- Evaluation of the Implementation of FDG-PET/CT and Staging Laparoscopy for Gastric Cancer in The Netherlands. Annals of Surgical Oncology (2020).
- “Four-Step Procedure” of laparoscopic exploration for gastric cancer in West China Hospital: a retrospective observational analysis from a high-volume institution in China. Surgical Endoscopy (2018).
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