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. Resection is the fundamental curative option for these patients while adjuvant therapies have also improved survival. Accurate staging forms the basis for which treatments are based. An understanding of the staging systems commonly used is important for physicians involved in the treatment of gastric cancer, and are reviewed. 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, and peritoneal cytology. 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.