The efficacy of pre-operative laparoscopy in the staging for gastric cancer

The only potential curative therapy forgastric cancer is the resection of both the tumor andthe regional lymph nodes at the early stage of thedisease. The majority of patients with gastric cancer inMalaysia have an advanced disease at initial diagnosis,and curative surgery is possible in less than 20% ofoperated cases. Acurate preoperative staging is crucialin determining the most suitable therapy and avoidingunnecessary attempts at curative surgery. Whilecomputed tomography remains as the most widely usedimaging modality for gastric cancer staging, its ability todetect local invasion, peritoneal and liver metastases islimited. In the recent years laparoscopy has become animportant component in the staging algorithm of gastriccancer. The aim of this review is to evaluate the efficacyof routine preoperative laparoscopic staging in themanagement of gastric cancer, and in particular describethe Malaysian experience.