{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:28:30Z","timestamp":1790044110627,"version":"4.0.1"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012921","name":"Royal College of Surgeons in Ireland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012921","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Gastrointest Canc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Staging laparoscopy with peritoneal lavage has become a cornerstone of gastric cancer staging, particularly for identifying occult peritoneal disease. Recent Dutch and European Delphi consensus studies have now established broad agreement on indications for staging laparoscopy, systematic peritoneal inspection, and technical aspects of peritoneal lavage. However, while consensus on how to perform the procedure has advanced substantially, there remains striking heterogeneity in how peritoneal lavage cytology specimens are handled and interpreted by pathology laboratories. A recent multicenter Japanese survey demonstrated more than a tenfold variation in cytology positivity rates across high-volume centres, closely associated with differences in laboratory methodology. Similar variability has been acknowledged in European centres but remains largely unquantified. This diagnostic inconsistency has become increasingly consequential as novel treatment strategies for cytology-positive and low-volume peritoneal disease, such as Normothermic Intraperitoneal and Systemic chemotherapy (NIPS), cytoreductive surgery with HIPEC, and pressurised intraperitoneal aerosol chemotherapy (PIPAC), enter clinical practice. Failure to address cytological heterogeneity risks misclassification, inappropriate treatment allocation, and inequitable access to emerging therapies. Future efforts should focus on extending consensus into the pathology laboratory and exploring molecular adjuncts, including peritoneal cell-free DNA, to reduce diagnostic variability.<\/jats:p>","DOI":"10.1007\/s12029-026-01404-2","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T02:11:44Z","timestamp":1770171104000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gastric Cancer Peritoneal Staging: Progress and Persistent Challenges"],"prefix":"10.1007","volume":"57","author":[{"given":"Eoghan","family":"Burke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"1404_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10120-016-0622-4","volume":"20","author":"Japanese Gastric Cancer Association","year":"2017","unstructured":"Japanese Gastric Cancer Association. 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Staging laparoscopy for gastric cancer: European consensus. Br J Surg. 2025;112:znaf144.","journal-title":"Br J Surg"},{"key":"1404_CR5","doi-asserted-by":"publisher","DOI":"10.1097\/AS9.0000000000000607","volume":"6","author":"K Fujiya","year":"2025","unstructured":"Fujiya K, Tokunaga M, Tone K, et al. A multicenter collaborative survey of peritoneal lavage cytology in gastric cancer surgery: interinstitutional methodological differences and positive rate. Ann Surg Open. 2025;6:e607.","journal-title":"Ann Surg Open"},{"issue":"Suppl","key":"1404_CR6","first-page":"8","volume":"112","author":"SJM van Hootegem","year":"2025","unstructured":"van Hootegem SJM, Guchelaar NAD, van der Sluis K, et al. Supplemental material S5: inventory assessment of cytological processing in steering committee centers. Br J Surg. 2025;112(Suppl):8.","journal-title":"Br J Surg"},{"key":"1404_CR7","doi-asserted-by":"crossref","first-page":"2135","DOI":"10.1016\/j.ejso.2017.07.019","volume":"43","author":"Y Yonemura","year":"2017","unstructured":"Yonemura Y, Ishibashi H, Hirano M, et al. Effects of neoadjuvant intraperitoneal\/systemic chemotherapy in gastric cancer with peritoneal metastasis. Eur J Surg Oncol. 2017;43:2135\u201342.","journal-title":"Eur J Surg Oncol"},{"key":"1404_CR8","doi-asserted-by":"publisher","first-page":"2028","DOI":"10.1200\/JCO.18.01688","volume":"37","author":"PE Bonnot","year":"2019","unstructured":"Bonnot PE, Piessen G, Kepenekian V, et al. Cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastases (CYTO-CHIP study). J Clin Oncol. 2019;37:2028\u201340.","journal-title":"J Clin Oncol"},{"issue":"1","key":"1404_CR9","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.ejso.2020.05.021","volume":"47","author":"M Alyami","year":"2021","unstructured":"Alyami M, Bonnot PE, Mercier F, Laplace N, Villeneuve L, Passot G, Bakrin N, Kepenekian V, Glehen O. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for unresectable peritoneal metastasis from gastric cancer. Eur J Surg Oncol. 2021;47(1):123\u20137.","journal-title":"Eur J Surg Oncol"},{"issue":"24","key":"1404_CR10","doi-asserted-by":"publisher","first-page":"1877","DOI":"10.1038\/s41388-024-03034-z","volume":"43","author":"K van der Sluis","year":"2024","unstructured":"van der Sluis K, Ito H. Improving diagnostic accuracy of identifying gastric cancer patients with peritoneal metastases: tumor-guided cell-free DNA analysis of peritoneal fluid. Oncogene. 2024;43(24):1877\u201382. https:\/\/doi.org\/10.1038\/s41388-024-03034-z.","journal-title":"Oncogene"}],"container-title":["Journal of Gastrointestinal Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12029-026-01404-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12029-026-01404-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12029-026-01404-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:03:38Z","timestamp":1781651018000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12029-026-01404-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,4]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1404"],"URL":"https:\/\/doi.org\/10.1007\/s12029-026-01404-2","relation":{},"ISSN":["1941-6636"],"issn-type":[{"value":"1941-6636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,4]]},"assertion":[{"value":"16 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was not required for this paper.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"32"}}