Staging laparoscopy in gastric cancer to detect peritoneal metastases: A systematic review and meta-analysis

Several imaging tests are used to stage gastric cancer; however the accuracy in the detection of peritoneal metastases is still low. Staging laparoscopy in gastric cancer has shown good results compared to imaging tests, particularly in patients with locally advanced disease signs. A search was conducted on electronic databases, and the studies were selected by methodological quality, inclusion and exclusion criteria. Data were analyzed using the Meta-Disc software version 1.4 to: describe primary results and explore homogeneity; explore threshold effect; calculate the sensitivity and specificity, negative and positive likelihood ratios; calculate the diagnostic odds ratio (DOR); and the summary ROC (sROC) curve. Five primary studies with a total of 240 participants were obtained. The overall sensitivity was 84.6%, and the overall specificity was 100%. The sensitivity and specificity homogeneity tests showed a Q value of 2.51 (P < 0.6434) with I(2) = 0, and Q = 0% (P = 1.0), I(2) = 0%, respectively. The DOR was 291.31 and positive and negative likelihood ratios were 0.197 and 49.711, respectively; while the AUC obtained by sROC was 98%. Staging laparoscopy shows good accuracy in the detection of peritoneal metastases and is an important diagnostic tool in the staging of gastric cancer.