Staging Laparoscopy in Gastric Cancer: Annals of Surgical Oncology | July 2026

Introduction:

Staging laparoscopy (SL) is recommended for patients with locally advanced gastric cancer to detect occult peritoneal metastases before curative treatment. However, its real-world utilization across Europe remains uncertain. This large GASTRODATA study evaluated the impact of staging laparoscopy on treatment pathways and clinical outcomes.

Why was this study needed?

• Staging laparoscopy is recommended by current guidelines but remains underutilized.
• Occult peritoneal metastases may be missed on conventional imaging.
• The impact of SL on multimodality treatment and surgical outcomes is unclear.
• Real-world European data on SL practice have been limited.
• Better staging may improve patient selection for curative treatment.

Results:

• Only one-third of patients underwent staging laparoscopy, highlighting substantial underutilization across European centers.
• Patients who did not undergo staging laparoscopy experienced higher postoperative complications, higher 90-day mortality, and were less likely to receive neoadjuvant or adjuvant chemotherapy.
• Absence of staging laparoscopy was associated with greater staging inaccuracy, more advanced pathological disease, and reduced use of multimodal treatment.

Clinical Impact:

This study reinforces the importance of routine staging laparoscopy in patients with locally advanced gastric cancer. Accurate staging facilitates appropriate multimodal treatment, avoids non-therapeutic surgery in patients with occult metastatic disease, and may improve short-term outcomes through better patient selection.

Bottom Line:

Staging laparoscopy remains underused despite guideline recommendations. Wider implementation may improve staging accuracy, optimize multimodality treatment, and potentially improve outcomes for patients with locally advanced gastric cancer.