{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:11:36Z","timestamp":1791821496935,"version":"4.3.4"},"reference-count":56,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Artificial intelligence is emerging as a promising tool in surgical oncology, with growing evidence suggesting potential applications in diagnostic support, intraoperative guidance, and perioperative risk assessment. In gastric cancer surgery, emerging applications range from AI-assisted endoscopic detection to data-driven perioperative risk prediction, while some technological developments, particularly in robotic autonomy, derive from broader surgical or experimental models that may inform future gastric procedures. Methods: A narrative review was conducted following established methodological standards, including the Scale for the Assessment of Narrative Review Articles (SANRA) and the Search\u2013Appraisal\u2013Synthesis\u2013Analysis (SALSA) framework. English-language studies indexed in PubMed, Scopus, Embase, and Web of Science up to October 2025 were included. Evidence was synthesized thematically across five domains: AI-assisted anatomical recognition and lymphadenectomy support, autonomous robotic systems, early cancer detection, perioperative predictive and frailty models, and ethical and regulatory considerations. Results: AI-based computer vision and deep learning algorithms have demonstrated promising capabilities for real-time anatomical recognition, surgical phase classification, and intraoperative guidance, although evidence of direct patient-level benefit remains limited. In diagnostic settings, AI-assisted endoscopy and Raman spectroscopy have been shown to improve early lesion detection and reduce dependence on operator experience. Predictive models, including MySurgeryRisk and AI-driven frailty assessments, may support individualized prehabilitation planning and perioperative risk stratification. Persistent limitations include small and heterogeneous datasets, insufficient external validation, and unresolved concerns related to data privacy, algorithmic interpretability, and medico-legal responsibility. Conclusions: Artificial intelligence is progressively emerging as a promising tool in gastric cancer surgery, integrating automation, advanced analytics, and human clinical reasoning. Its safe and ethical adoption requires robust validation, transparent governance, and continuous surgeon oversight. When developed within human-centered and ethically grounded frameworks, AI can augment, rather than replace, surgical expertise, potentially advancing precision, safety, and equity in oncologic care.<\/jats:p>","DOI":"10.3390\/jcm15062208","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:36:48Z","timestamp":1773423408000},"page":"2208","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Artificial Intelligence Applications in Gastric Cancer Surgery: Bridging Early Diagnosis and Responsible Precision Medicine"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6462-2090","authenticated-orcid":false,"given":"Silvia","family":"Malerba","sequence":"first","affiliation":[{"name":"Department of General Surgery and Surgical Oncology, \u201cSaint Wojciech\u201d Hospital, \u201cNicolaus Copernicus\u201d Health Center, 80-000 Gda\u0144sk, Poland"},{"name":"Department of Precision and Regenerative Medicine and Ionian Area, University of Bari \u201cAldo Moro\u201d, 70110 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8152-8017","authenticated-orcid":false,"given":"Miljana","family":"Vladimirov","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Center OWL\u2014Campus Hospital Lippe, 32756 Detmold, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7336-1366","authenticated-orcid":false,"given":"Aman","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Mahatma Gandhi Medical College and Research Institute, Pondicherry, Cuddalore Rd, ECR, Pillayarkuppam, Puducherry 607402, India"},{"name":"Department of Medicine, Adesh Institute of Medical Sciences and Research, Bathinda 151001, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3692-8962","authenticated-orcid":false,"given":"Audrius","family":"Dulskas","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania"},{"name":"Department of Surgical Oncology, National Cancer Institute, 03101 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustinas","family":"Bau\u0161ys","sequence":"additional","affiliation":[{"name":"Institute of Biosciences, Life Science Center, Vilnius University, 01513 Vilnius, Lithuania"},{"name":"Department of General and Abdominal Surgery and Oncology, National Cancer Institute, 08406 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1506-9735","authenticated-orcid":false,"given":"Tomasz","family":"Cwalinski","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Surgical Oncology, \u201cSaint Wojciech\u201d Hospital, \u201cNicolaus Copernicus\u201d Health Center, 80-000 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0988-5875","authenticated-orcid":false,"given":"Sergii","family":"Girnyi","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Surgical Oncology, \u201cSaint Wojciech\u201d Hospital, \u201cNicolaus Copernicus\u201d Health Center, 80-000 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3079-3502","authenticated-orcid":false,"given":"Jaroslaw","family":"Skokowski","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Surgical Oncology, \u201cSaint Wojciech\u201d Hospital, \u201cNicolaus Copernicus\u201d Health Center, 80-000 Gda\u0144sk, Poland"},{"name":"Department of Medicine, Academy of Applied Medical and Social Sciences-AMiSNS (Akademia Medycznych I Spolecznych Nauk Stosowanych), 52-300 Elbl\u0105g, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3962-8746","authenticated-orcid":false,"given":"Ruslan","family":"Duka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dnipro State Medical University, Volodymyra Vernadskoho St. 9, 49044 Dnipro, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9589-8364","authenticated-orcid":false,"given":"Robert","family":"Molchanov","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dnipro State Medical University, Volodymyra Vernadskoho St. 9, 49044 Dnipro, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bojan","family":"Jovanovic","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Emergency Center, University Clinical Center of Nis, 18000 Nis, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Antonio","family":"Ciarleglio","sequence":"additional","affiliation":[{"name":"Department of General Surgery and HPB, Azienda Ospedaliera Perugia, 06129 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Brolese","sequence":"additional","affiliation":[{"name":"Department of General Surgery and HPB, Azienda Provinciale per i Servizi Sanitari di Trento (APSS), 38123 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kebebe Bekele","family":"Gonfa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Madda Walabu University, Goba 4540, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-6437","authenticated-orcid":false,"given":"Abdi Tesemma","family":"Demmo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Madda Walabu University, Goba 4540, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2173-1294","authenticated-orcid":false,"given":"Zilvinas","family":"Dambrauskas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"P\u00e9rez Bonet","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hospital Regional Maria Inmaculada, Florencia 180001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9297-4894","authenticated-orcid":false,"given":"Mario","family":"Testini","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area, University of Bari \u201cAldo Moro\u201d, 70110 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Paolo","family":"Prete","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area, University of Bari \u201cAldo Moro\u201d, 70110 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7710-9109","authenticated-orcid":false,"given":"Valentin","family":"Calu","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Medicine and Pharmacy Carol Davila, 010001 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5426-5985","authenticated-orcid":false,"given":"Natale","family":"Calomino","sequence":"additional","affiliation":[{"name":"Kidney Transplant Unit, Department of Medicine Surgery and Neuroscience, University Hospital of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5110-6831","authenticated-orcid":false,"given":"Vikas","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik 422001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5716-2009","authenticated-orcid":false,"given":"Aleksandar","family":"Karamarkovic","sequence":"additional","affiliation":[{"name":"Zvezdara University Clinical Center, \u201cNikola Spasi\u0107\u201d Surgical Clinic, Faculty of Medicine, University of Belgrade, Dimitrija Tucovica 161, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, Dr Subotica 1, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karol","family":"Polom","sequence":"additional","affiliation":[{"name":"Department of Medicine, Academy of Applied Medical and Social Sciences-AMiSNS (Akademia Medycznych I Spolecznych Nauk Stosowanych), 52-300 Elbl\u0105g, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3408-4540","authenticated-orcid":false,"given":"Adel","family":"Abou-Mrad","sequence":"additional","affiliation":[{"name":"Department of Surgery, Centre Hospitalier Universitaire d\u2019Orl\u00e9ans, 45000 Orl\u00e9ans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3784-6555","authenticated-orcid":false,"given":"Rodolfo J.","family":"Oviedo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Nacogdoches Medical Center, Nacogdoches, TX 75962, USA"},{"name":"Department of Surgery, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX 77001, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2030-6712","authenticated-orcid":false,"given":"Yogesh","family":"Vashist","sequence":"additional","affiliation":[{"name":"Department of Medicine, Academy of Applied Medical and Social Sciences-AMiSNS (Akademia Medycznych I Spolecznych Nauk Stosowanych), 52-300 Elbl\u0105g, Poland"},{"name":"Department of Surgical Oncology, General Visceral Thoracic and Vascular Surgery, Dietrich-Bonhoeffer-Clinic, 17033 Neubrandenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9777-9588","authenticated-orcid":false,"given":"Luigi","family":"Marano","sequence":"additional","affiliation":[{"name":"Department of Medicine, Academy of Applied Medical and Social Sciences-AMiSNS (Akademia Medycznych I Spolecznych Nauk Stosowanych), 52-300 Elbl\u0105g, Poland"},{"name":"Department of Surgery, Dnipro State Medical University, Volodymyra Vernadskoho St. 9, 49044 Dnipro, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.18632\/aging.206190","article-title":"Deep learning and generative artificial intelligence in aging research and healthy longevity medicine","volume":"17","author":"Wilczok","year":"2025","journal-title":"Aging"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.dsp.2017.10.011","article-title":"Methods for interpreting and understanding deep neural networks","volume":"73","author":"Montavon","year":"2018","journal-title":"Digit. 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