Gastric cancer staging

Worldwide, gastric adenocarcinoma is one of the most commonly found malignancies, and one of the most common causes of cancer-related death. Although adjuvant therapies have improved survival, resection remains the fundamental curative option for gastric cancer patients. Accurate staging forms the basis for which treatments are selected. An understanding of the staging systems commonly used is important for physicians involved in the treatment of gastric cancer. In addition, several staging modalities are routinely prescribed in an attempt to accurately stage the patient with gastric cancer. Each of these staging modalities has their own benefits and drawbacks with varying degrees of accuracy, sensitivity and specificity. The following staging modalities will be reviewed in detail: computed tomography, magnetic resonance imaging, abdominal ultrasound, ¹⁸Fluorodeoxyglucose-positron emission tomography, esophagogastroduodenoscopy, endoscopic ultrasound, staging laparoscopy, peritoneal cytology and sentinel lymph node biopsy. The ultimate goal is correlation between staging modalities and pathology findings such that accurate staging is performed with delivery of the most appropriate stage-specific treatment.