The Importance of Staging Laparoscopy Before Treatment for Gastric Cancer
- 1 day ago
- 2 min read
Ostowari A, Chen KT, Hasjim BJ, Montero S, Sedighim S, Tajik F, Roman M, Dayyani F, Daly S, Smith BR, Nguyen NT, Eng OS, O'Leary MP, Senthil M. Underutilization of Staging Laparoscopy Prior to Neoadjuvant Systemic Therapy in Gastric Cancer. Ann Surg Oncol. 2026 Feb;33(2):1343-1349. doi: 10.1245/s10434-025-18547-4. Epub 2025 Oct 17. PMID: 41107646; PMCID: PMC12765731.
When stomach (gastric) cancer or gastroesophageal junction (GEJ) cancer is diagnosed, doctors often recommend chemotherapy before surgery. This approach, called neoadjuvant therapy, is intended to shrink the tumor and improve outcomes. However, accurately determining whether the cancer has already spread inside the abdomen is critical before starting treatment.
This recent study examined how often patients receive a procedure called staging laparoscopy before beginning chemotherapy and how this procedure impacts treatment planning.
What Is Staging Laparoscopy?
Staging laparoscopy is a minimally invasive procedure in which a surgeon inserts a small camera into the abdomen through tiny incisions. This allows doctors to directly examine the abdominal cavity and detect small areas of cancer spread—particularly to the peritoneum (the lining of the abdomen)—that may not be visible on imaging scans such as CT scans.
Identifying this spread is important because it can significantly change the recommended treatment plan.
What the Study Found
Researchers reviewed patients with gastric and GEJ cancers who were referred for chemotherapy before surgery. They found:
Only about 30% of patients underwent staging laparoscopy before starting chemotherapy.
Among those who did have the procedure, 38% were found to have previously undetected cancer spread within the abdomen.
Detecting peritoneal metastases changed treatment decisions and overall prognosis.
These findings suggest that imaging alone may miss a substantial number of cases where cancer has already spread.
Why This Matters for Patients
If cancer has spread to the peritoneum, surgery may not be the most effective first step. Identifying this early can help:
Avoid unnecessary major surgery
Adjust treatment plans appropriately
Ensure patients receive the most suitable therapy from the beginning
This study highlights the value of staging laparoscopy as an important step in treatment planning for certain patients with gastric and GEJ cancers.
Questions Patients May Consider Asking
If you or a loved one is preparing to start chemotherapy before surgery for gastric or GEJ cancer, you may want to ask your care team:
Has staging laparoscopy been considered in my case?
Could this procedure provide additional information about whether the cancer has spread?
How would the findings change my treatment plan?
Being informed and asking questions can help ensure that treatment decisions are based on the most complete and accurate information available.
