{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T04:15:10Z","timestamp":1785644110549,"version":"3.56.0"},"reference-count":21,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This study aimed to assess the diagnostic accuracy and prognostic significance of staging laparoscopy (SL) compared to computed tomography (CT) and positron emission tomography\u2013computed tomography (PET-CT) in gastric cancer staging. We evaluated the ability of SL to detect occult peritoneal metastases and influence of SL on survival outcomes across cancer stages and treatment approaches. Materials and Methods: In this retrospective cohort study, 95 patients with gastric cancer underwent preoperative assessment using CT, PET-CT, and SL between 2018 and 2024. Diagnostic performance metrics were calculated for SL, CT, and PET\/CT across the local, locally advanced, and metastatic stages. Survival outcomes were analyzed using Kaplan\u2013Meier curves, and comparisons were made using log-rank tests. A multivariable Cox proportional hazards model incorporating interaction terms was used to determine the independent prognostic factors affecting survival, focusing on SL findings and cytology results. Results: The cohort comprised 75 males (78.9%) and 20 females (21.1%), with a mean age of 57.4 \u00b1 10.1 years. The tumor location distribution was predominant in the corpus (31.1%) and cardia. Tumor staging revealed that 48.1% were classified as T3 and 28.8% as T4, respectively. Diagnostic accuracy analysis showed that SL outperformed CT and PET-CT in detecting peritoneal metastasis across all stages. Specifically, SL demonstrated a sensitivity and specificity of 85% and 95% for local disease, 92% and 80% for locally advanced disease, and 95% and 99% for metastatic disease, significantly exceeding those of CT and PET-CT. Patients with SL findings had a median overall survival (OS) of 30 months compared with 20 months for those assessed only with CT and PET-CT (p &lt; 0.05). The stage-specific median OS for SL patients was 40 months in the local, 25 months in the locally advanced (p &lt; 0.05), and 15 months in the metastatic disease (p &lt; 0.01) groups, indicating significant survival benefits. Multivariable Cox regression identified SL findings as an independent factor associated with reduced mortality risk (HR: 0.70, 95% CI: 0.50\u20130.90, p &lt; 0.01), while positive cytology findings predicted poorer survival (HR: 1.80, 95% CI: 1.25\u20132.60, p &lt; 0.01). Interaction terms revealed that SL yielded greater survival benefits in patients with metastatic disease (hazard ratio [HR]: 0.60, p &lt; 0.01) and those undergoing systemic therapy (HR: 0.75, p = 0.04). Conclusions: SL provides superior diagnostic accuracy and prognostic information for advanced gastric cancer staging compared with CT and PET-CT. By accurately detecting peritoneal metastasis, SL aids in optimizing treatment plans, particularly in advanced stages, thus potentially improving patient outcomes.<\/jats:p>","DOI":"10.3390\/medicina60122079","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T03:59:43Z","timestamp":1734580783000},"page":"2079","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnostic Efficacy of Staging Laparoscopy Compared to CT and PET-CT in Gastric Cancer: A Retrospective Cohort Analysis"],"prefix":"10.3390","volume":"60","author":[{"given":"Cem Batuhan","family":"Ofluo\u011flu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Surgery, Sancaktepe Sehit Prof. Dr. \u0130lhan Varank Training and Research Hospital, University of Health Sciences, 34147 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2434-0045","authenticated-orcid":false,"given":"Isa Caner","family":"Ayd\u0131n","sequence":"additional","affiliation":[{"name":"Gastroenterology Surgery Cl\u0131n\u0131c, Zonguldak Atat\u00fcrk State Hospital, Health M\u0131n\u0131stry of Turk\u0131sh Republ\u0131c, 34147 Zonguldak, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4049-7595","authenticated-orcid":false,"given":"F\u0131rat","family":"M\u00fclk\u00fct","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Sancaktepe Sehit Prof. Dr. \u0130lhan Varank Training and Research Hospital, University of Health Sciences, 34147 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"Uzun","sequence":"additional","affiliation":[{"name":"Gastroenterology Surgery Cl\u0131n\u0131c, Ko\u015fuyolu H\u0131gh Spec\u0131al\u0131zat\u0131on Educat\u0131on and Research Hosp\u0131tal, University of Health Sciences, 34147 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziz Serkan","family":"Senger","sequence":"additional","affiliation":[{"name":"Gastroenterology Surgery Cl\u0131n\u0131c, Ko\u015fuyolu H\u0131gh Spec\u0131al\u0131zat\u0131on Educat\u0131on and Research Hosp\u0131tal, University of Health Sciences, 34147 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sel\u00e7uk","family":"G\u00fclmez","sequence":"additional","affiliation":[{"name":"Gastroenterology Surgery Cl\u0131n\u0131c, Ko\u015fuyolu H\u0131gh Spec\u0131al\u0131zat\u0131on Educat\u0131on and Research Hosp\u0131tal, University of Health Sciences, 34147 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U\u011fur","family":"Duman","sequence":"additional","affiliation":[{"name":"General Surgery Cl\u0131n\u0131c, Bursa Y\u00fcksek \u0130htisas Training and Research Hospital, University of Health Sciences, Bursa Provincial Health Directorate, 16290 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erdal","family":"Polat","sequence":"additional","affiliation":[{"name":"Gastroenterology Surgery Cl\u0131n\u0131c, Ko\u015fuyolu H\u0131gh Spec\u0131al\u0131zat\u0131on Educat\u0131on and Research Hosp\u0131tal, University of Health Sciences, 34147 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Duman","sequence":"additional","affiliation":[{"name":"Gastroenterology Surgery Cl\u0131n\u0131c, Ko\u015fuyolu H\u0131gh Spec\u0131al\u0131zat\u0131on Educat\u0131on and Research Hosp\u0131tal, University of Health Sciences, 34147 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.3748\/wjg.v28.i12.1187","article-title":"Epidemiology of stomach cancer","volume":"28","author":"Ilic","year":"2022","journal-title":"World J. 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