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18F-fludeoxyglucose–positron emission tomography/computed tomography and laparoscopy for staging of locally advanced gastric cancer: A multicenter prospective Dutch cohort study (PLASTIC)

JAMA Dec 13, 2021

Gertsen EC, Brenkman HJF, van Hillegersberg R, et al. - As debate remains concerning the optimal staging for gastric cancer, researchers sought to determine if 18F-fludeoxyglucose–positron emission tomography with computed tomography (FDG-PET/CT) and staging laparoscopy (SL), in addition to initial staging by means of gastroscopy and CT, is beneficial in patients with locally advanced gastric cancer.

  • A multicenter cohort study including 394 patients with locally advanced, clinically curable gastric adenocarcinoma (≥ cT3 and/or N+, M0 category based on CT).

  • Metastatic disease was detected in 3% of patients using FDG-PET/CT and metastatic or noncurable disease was detected in 19% of patients via staging laparoscopy.

  • There was a change in treatment intent from curative to palliative in 16% of the patients.

  • Overall findings suggest limited additive value of FDG-PET/CT, but staging laparoscopy adds substantially to the staging process in patients with locally advanced gastric cancer.

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