Abstract
Endoscopic ultrasound (EUS) is recommended for staging of locoregional gastric cancer (GC). In patients without imaging evidence of distant metastasis, guidelines recommend diagnostic staging laparoscopy (DSL) with or without peritoneal washings to detect radiographically occult peritoneal metastasis (M1 disease). DSL can help GC patients avert the cost, morbidity, and mortality associated with non therapeutic laparotomy, but has only been found to be cost effective when used selectively. Classification of GC patients at low vs. high risk for laparoscopic (lapM1) disease using EUS tumor size (T) and nodal status (N) has been proposed previously [1], but not externally validated. We aimed to validate an EUS-based risk classification system predicting risk for lapM1 disease.
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