ArticleAnnals of surgical oncology2026
The Clinical Value of Laparoscopic Exploration in Diagnosing and Dynamically Assessing Occult Peritoneal Metastasis in Gastric Cancer.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Carbohydrate antigen 72-4 and tumor-associated glycoprotein 72 - tumor marker: Past, present and future.World journal of gastrointestinal pathophysiology · 2026Review
- ASO Author Reflections: Is Intervening in Metabolic Syndrome a New Direction for Improving the Prognosis After Curative-Intent Resection of Perihilar Cholangiocarcinoma?Annals of surgical oncology · 2026Article
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12 authors.
Funding
Abstract
backgroundImaging-invisible occult peritoneal metastasis (OPM) is not uncommon in patients with gastric or gastroesophageal junction adenocarcinoma (G/GEJC). This study aimed to identify the risk factors for OPM detected by laparoscopic exploration, characterize the dynamic changes in OPM on laparoscopic re-exploration after treatment, and evaluate their prognostic significance.
methodsThe study included 653 patients with newly diagnosed cT1-2N+/T3-4bNx, cM0 G/GEJC who underwent laparoscopic exploration and peritoneal lavage fluid cytology between July 2018 and June 2025. Of these 653 patients, 140 underwent repeat laparoscopy (the laparoscopic re-exploration cohort) with cytology after systemic therapy. Risk factors for OPM were identified by logistic regression and survival by Kaplan-Meier analysis.
resultsOn initial laparoscopy, 22.2% (145/653) of the patients received a diagnosis of OPM+, whereas 77.8% (508/653) received a diagnosis of OPM-. Younger patients (age < 35 years), better Eastern Cooperative Oncology Group (ECOG) status (0 score), primary gastric cancers, CA72-4 (≥ 6.9 U/mL), sT4a/b stage, and minimal ascites (vs no ascites) were associated with OPM+. Patients with OPM+ initially had significantly worse median overall survival than OPM- patients (15.9 months vs not reached; P < 0.001). In the laparoscopic re-exploration cohort, 26.4% (37/140) showed changes in OPM status. Specifically, among the initial OPM+ patients, 57.1% (16/28) were converted to OPM-, whereas 18.8% (21/112) of the initial OPM- patients were converted to OPM+. Persistent OPM- and conversion to OPM- were associated with better survival than persistent OPM+ and conversion to OPM+.
conclusionIn locally advanced G/GEJC, OPM is common. Laparoscopic exploration is essential for detecting OPM, and dynamic laparoscopic evaluation of peritoneal metastasis status holds significant prognostic value.
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