Evidence map›Paper›PMID 40867292›Full record

ArticleCancers2025

A Step Toward a Global Consensus on Gastric Cancer Resectability Integrating Artificial Intelligence-Based Consensus Modelling.

Katarzyna Gęca, Franco Roviello, Magdalena Skórzewska, Radosław Mlak, Wojciech P Polkowski, Icrgc Collaborators

Abstract read
In one paragraph

Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Katarzyna GęcaDepartment of Surgical Oncology, Medical University of Lublin, 20-080 Lublin, Poland.ORCID 0000-0001-5024-2559
Franco RovielloGeneral and Surgical Oncology Department, University of Siena, 53100 Siena, Italy.
Magdalena SkórzewskaDepartment of Surgical Oncology, Medical University of Lublin, 20-080 Lublin, Poland.ORCID 0000-0002-5004-9940
Radosław MlakDepartment of Laboratory Diagnostics, Medical University of Lublin, 20-093 Lublin, Poland.ORCID 0000-0001-7399-8340
Wojciech P PolkowskiDepartment of Surgical Oncology, Medical University of Lublin, 20-080 Lublin, Poland.ORCID 0000-0001-6455-5636
Icrgc Collaborators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgical resection remains central to the curative treatment of locally advanced gastric cancer (GC), yet global variability persists in defining resectability, particularly in complex scenarios such as multivisceral invasion, positive peritoneal cytology (CY1), or oligometastatic disease. The Intercontinental Criteria of Resectability for Gastric Cancer (ICRGC) project was developed to address this gap by combining expert surgical input with artificial intelligence (AI)-based reasoning.

methodsA two-stage prospective survey was conducted during the 2024 European Gastric Cancer Association (EGCA) meeting. Fifty-eight surgical oncologists completed a 36-item questionnaire on resectability, strategy, and quality metrics. Subsequently, they reviewed AI-generated responses based on current clinical guidelines and completed a second round. Concordance between human and AI responses was classified as full, partial, or discordant, and changes in surgeon opinions were statistically analyzed.

resultsSubstantial agreement was observed in evidence-based domains. Seventy-nine percent of surgeons agreed with AI on distinguishing technical from oncological resectability. In cT4b cases, 61% supported restricting multivisceral resection to high-volume centers. Similar alignment was found in CY1 (54%) and N3 nodal disease (63%). Partial concordance appeared in areas requiring individualized judgment, such as peritonectomy or bulky-N disease. After AI exposure, surgeon responses shifted toward guideline-consistent decisions, including increased support for cytoreductive surgery only when CC0/1 was achievable and stricter classification of R2 resections as unresectable. Following AI exposure, 27.1% of surgeons changed at least one answer in alignment with AI recommendations, with statistically significant shifts observed in items related to surgical margin definition (

conclusionsThe ICRGC study demonstrates that AI-driven consensus modeling can replicate expert reasoning in complex surgical oncology and serve as a catalyst for harmonizing global practice. These findings suggest that AI-supported consensus modeling may complement expert surgical reasoning and promote greater consistency in decision-making, particularly in controversial or ambiguous cases.

Indexed as

artificial intelligencegastric cancerICRGC projectresectability

Identifiers

PMID40867292
PMCPMC12384817

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.