[How accurate is preoperative staging as a basis for treatment decisions in gastric carcinoma?]

The treatment of advanced gastric carcinoma by various neoadjuvant and adjuvant multimodal therapy regimes is under current investigation to improve the poor outcome of these patients. Therefore, pretherapeutic tumor staging according to the TNM classification is essential for the optimal application of various therapeutic modalities. According to recent studies, endoscopic ultrasonography (EUS) is the most sensitive technique in measuring tumor infiltration (T-staging). In addition, although less reliable compared to the T-staging, the sensitivity of EUS in assessing lymph node status (N-staging) is superior to computed tomography and conventional ultrasound. Pretherapeutic laparoscopic investigation may give additional important information about tumor stage. This overview describes the significance of various diagnostic techniques that can be applied in tumor staging investigations.