Staging laparoscopy is used to more accurately stage patients with gastric cancer and to prevent unnecessary invasive operations by detecting peritoneal dissemination and occult metastases, per Sanjeevaiah and colleagues. According to the NCCN guidelines, laparoscopy is recommended for medically fit patients with potentially resectable stage cT1b or greater locoregional disease. Further, laparoscopy allows for sampling of peritoneal fluid for cytologic examination, exclusion of small liver metastases, and evaluation of abdominal lymph nodes. Studies have shown that approximately 20%-30% of patients with peritoneal metastases had a negative CT, highlighting the limitations of radiographic staging.
Upper GI series and barium swallow testing are considered when obstructive symptoms of gastric cancer are present or when endoscopic examination is possible owing to a proximal tumor.
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Cite this: Daniel Catenacci. Fast Five Quiz: Gastric Cancer Diagnosis - Medscape - Aug 24, 2022.