{"id":"https://openalex.org/W7225657535","doi":"https://doi.org/10.1097/sp9.0000000000000077","title":"Staging laparoscopy in locally advanced gastric adenocarcinoma: diagnostic yield, predictors of occult metastatic disease, and development of a clinical prediction score","display_name":"Staging laparoscopy in locally advanced gastric adenocarcinoma: diagnostic yield, predictors of occult metastatic disease, and development of a clinical prediction score","publication_year":2026,"publication_date":"2026-11-09","ids":{"openalex":"https://openalex.org/W7225657535","doi":"https://doi.org/10.1097/sp9.0000000000000077"},"language":"en","primary_location":{"id":"doi:10.1097/sp9.0000000000000077","doi":"https://doi.org/10.1097/sp9.0000000000000077","is_oa":true,"landing_page_url":"https://doi.org/10.1097/sp9.0000000000000077","pdf_url":null,"source":{"id":"https://openalex.org/S2898569351","display_name":"International Journal of Surgery Protocols","issn_l":"2468-3574","issn":["2468-3574"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Surgery Protocols","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1097/sp9.0000000000000077","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161333539","display_name":"Attullah Khan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800200783","display_name":"Lady Reading Hospital","ror":"https://ror.org/01eq8c489","country_code":"PK","type":"healthcare","lineage":["https://openalex.org/I2800200783"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Attullah Khan","raw_affiliation_strings":["FCPS Surgical Oncology, Lady Reading Hospital, Peshawar, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"FCPS Surgical Oncology, Lady Reading Hospital, Peshawar, Pakistan","institution_ids":["https://openalex.org/I2800200783"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5123197629","display_name":"Muhammad Daud","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800200783","display_name":"Lady Reading Hospital","ror":"https://ror.org/01eq8c489","country_code":"PK","type":"healthcare","lineage":["https://openalex.org/I2800200783"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Muhammad Daud","raw_affiliation_strings":["Resident General Surgical, Lady Reading Hospital, Peshawar, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Resident General Surgical, Lady Reading Hospital, Peshawar, Pakistan","institution_ids":["https://openalex.org/I2800200783"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5010903412","display_name":"Ihtisham Ul Haq","orcid":"https://orcid.org/0000-0002-0806-6907","observed_orcids":["https://orcid.org/0000-0002-0806-6907","https://orcid.org/0009-0000-7890-2694","https://orcid.org/0009-0003-5774-5281","https://orcid.org/0009-0004-8119-590X"]},"institutions":[{"id":"https://openalex.org/I2800200783","display_name":"Lady Reading Hospital","ror":"https://ror.org/01eq8c489","country_code":"PK","type":"healthcare","lineage":["https://openalex.org/I2800200783"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Ihtisham Ul Haq","raw_affiliation_strings":["FCPS Surgical Oncology, Lady Reading Hospital, Peshawar, Pakistan"],"raw_orcid":"https://orcid.org/0009-0003-5774-5281","affiliations":[{"raw_affiliation_string":"FCPS Surgical Oncology, Lady Reading Hospital, Peshawar, Pakistan","institution_ids":["https://openalex.org/I2800200783"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161324478","display_name":"Bahar Ali","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800200783","display_name":"Lady Reading Hospital","ror":"https://ror.org/01eq8c489","country_code":"PK","type":"healthcare","lineage":["https://openalex.org/I2800200783"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Bahar Ali","raw_affiliation_strings":["Resident General Surgical, Lady Reading Hospital, Peshawar, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Resident General Surgical, Lady Reading Hospital, Peshawar, Pakistan","institution_ids":["https://openalex.org/I2800200783"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161310610","display_name":"Sohaib Farrukh","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800200783","display_name":"Lady Reading Hospital","ror":"https://ror.org/01eq8c489","country_code":"PK","type":"healthcare","lineage":["https://openalex.org/I2800200783"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Sohaib Farrukh","raw_affiliation_strings":["Resident General Surgical, Lady Reading Hospital, Peshawar, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Resident General Surgical, Lady Reading Hospital, Peshawar, Pakistan","institution_ids":["https://openalex.org/I2800200783"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161317490","display_name":"Izhar Ul Haq Khaleel","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800200783","display_name":"Lady Reading Hospital","ror":"https://ror.org/01eq8c489","country_code":"PK","type":"healthcare","lineage":["https://openalex.org/I2800200783"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Izhar Ul Haq Khaleel","raw_affiliation_strings":["Resident General Surgical, Lady Reading Hospital, Peshawar, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Resident General Surgical, Lady Reading Hospital, Peshawar, Pakistan","institution_ids":["https://openalex.org/I2800200783"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161327894","display_name":"Sikandar Khan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800200783","display_name":"Lady Reading Hospital","ror":"https://ror.org/01eq8c489","country_code":"PK","type":"healthcare","lineage":["https://openalex.org/I2800200783"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Sikandar Khan","raw_affiliation_strings":["Resident General Surgical, Lady Reading Hospital, Peshawar, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Resident General Surgical, Lady Reading Hospital, Peshawar, Pakistan","institution_ids":["https://openalex.org/I2800200783"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161339999","display_name":"Muhammad Mustafa Arif","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Muhammad Mustafa Arif","raw_affiliation_strings":["Agha Khan Hospital, Peshawar, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Agha Khan Hospital, Peshawar, Pakistan","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":1000,"currency":"USD","value_usd":1000},"apc_paid":{"value":1000,"currency":"USD","value_usd":1000},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10696","display_name":"Gastric Cancer Management and Outcomes","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10696","display_name":"Gastric Cancer Management and Outcomes","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12064","display_name":"Intraperitoneal and Appendiceal Malignancies","score":0.0012000000569969416,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11378","display_name":"Gastrointestinal Bleeding Diagnosis and Treatment","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2715","display_name":"Gastroenterology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/staging-laparoscopy","display_name":"staging laparoscopy","score":0.9919999837875366},{"id":"https://openalex.org/keywords/locally-advanced-gastric-adenocarcinoma","display_name":"locally advanced gastric adenocarcinoma","score":0.9739999771118164},{"id":"https://openalex.org/keywords/occult-metastatic-disease","display_name":"occult metastatic disease","score":0.8550000190734863},{"id":"https://openalex.org/keywords/peritoneal-metastases","display_name":"peritoneal carcinomatosis","score":0.8939999938011169},{"id":"https://openalex.org/keywords/distant-metastasis","display_name":"distant metastasis","score":0.8399999737739563},{"id":"https://openalex.org/keywords/clinical-prediction-score","display_name":"clinical prediction score","score":0.8980000019073486},{"id":"https://openalex.org/keywords/risk-stratification","display_name":"risk stratification","score":0.6579999923706055},{"id":"https://openalex.org/keywords/ca19-9","display_name":"CA19-9","score":0.8240000009536743},{"id":"https://openalex.org/keywords/diagnostic-yield","display_name":"diagnostic yield","score":0.7129999995231628},{"id":"https://openalex.org/keywords/gastric-cancer-staging","display_name":"gastric cancer staging","score":0.5230000019073486}],"concepts":[{"id":"https://openalex.org/C520017518","wikidata":"https://www.wikidata.org/wiki/Q178934","display_name":"Occult","level":3,"score":0.8795999884605408},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8568999767303467},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.6067000031471252},{"id":"https://openalex.org/C58471807","wikidata":"https://www.wikidata.org/wiki/Q327120","display_name":"Receiver operating characteristic","level":2,"score":0.5875999927520752},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.5828999876976013},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.5773000121116638},{"id":"https://openalex.org/C2780496750","wikidata":"https://www.wikidata.org/wiki/Q193889","display_name":"Ascites","level":2,"score":0.5288000106811523},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.5070000290870667},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.49219998717308044},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.4251999855041504},{"id":"https://openalex.org/C2780047204","wikidata":"https://www.wikidata.org/wiki/Q675754","display_name":"Laparoscopy","level":2,"score":0.40860000252723694},{"id":"https://openalex.org/C146357865","wikidata":"https://www.wikidata.org/wiki/Q1123245","display_name":"Stage (stratigraphy)","level":2,"score":0.40290001034736633},{"id":"https://openalex.org/C50382708","wikidata":"https://www.wikidata.org/wiki/Q223218","display_name":"Proportional hazards model","level":2,"score":0.4020000100135803},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.37439998984336853},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.32499998807907104},{"id":"https://openalex.org/C2992389814","wikidata":"https://www.wikidata.org/wiki/Q2459684","display_name":"Cancer antigen","level":3,"score":0.3246000111103058},{"id":"https://openalex.org/C164465091","wikidata":"https://www.wikidata.org/wiki/Q7248371","display_name":"Prognostic variable","level":3,"score":0.3075999915599823},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.2994000017642975},{"id":"https://openalex.org/C198433322","wikidata":"https://www.wikidata.org/wiki/Q3910099","display_name":"Predictive value of tests","level":2,"score":0.29499998688697815},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.29280000925064087},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.2741999924182892},{"id":"https://openalex.org/C36454342","wikidata":"https://www.wikidata.org/wiki/Q245341","display_name":"Radiography","level":2,"score":0.25699999928474426},{"id":"https://openalex.org/C170964787","wikidata":"https://www.wikidata.org/wiki/Q7611170","display_name":"Stepwise regression","level":2,"score":0.25029999017715454}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1097/sp9.0000000000000077","doi":"https://doi.org/10.1097/sp9.0000000000000077","is_oa":true,"landing_page_url":"https://doi.org/10.1097/sp9.0000000000000077","pdf_url":null,"source":{"id":"https://openalex.org/S2898569351","display_name":"International Journal of Surgery Protocols","issn_l":"2468-3574","issn":["2468-3574"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Surgery Protocols","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1097/sp9.0000000000000077","doi":"https://doi.org/10.1097/sp9.0000000000000077","is_oa":true,"landing_page_url":"https://doi.org/10.1097/sp9.0000000000000077","pdf_url":null,"source":{"id":"https://openalex.org/S2898569351","display_name":"International Journal of Surgery Protocols","issn_l":"2468-3574","issn":["2468-3574"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Journal of Surgery Protocols","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":20,"referenced_works":["https://openalex.org/W1997735831","https://openalex.org/W2089194878","https://openalex.org/W2089828697","https://openalex.org/W2124242050","https://openalex.org/W2412211030","https://openalex.org/W2470066271","https://openalex.org/W2473153275","https://openalex.org/W2558944832","https://openalex.org/W2772463685","https://openalex.org/W2913160101","https://openalex.org/W2969617557","https://openalex.org/W2977009930","https://openalex.org/W3010546551","https://openalex.org/W3210667831","https://openalex.org/W4210511445","https://openalex.org/W4211130279","https://openalex.org/W4288734447","https://openalex.org/W4312221676","https://openalex.org/W4392203550","https://openalex.org/W4412661689"],"related_works":["https://openalex.org/W7163739948","https://openalex.org/W3188581372","https://openalex.org/W2966544226","https://openalex.org/W4412041446","https://openalex.org/W2977009930","https://openalex.org/W157349849","https://openalex.org/W4406597168","https://openalex.org/W4315621535","https://openalex.org/W2404015093","https://openalex.org/W4408168215"],"abstract_inverted_index":{"Background:":[0],"Computed":[1],"tomography":[2],"(CT)":[3],"fails":[4],"to":[5,133,263,271],"detect":[6],"occult":[7,34,244],"peritoneal":[8],"and":[9,30,55,81,101,176,196,219,235],"distant":[10],"metastases":[11,137],"in":[12,108,119,221,247],"a":[13,57,64,259],"significant":[14],"minority":[15],"of":[16,47,52,70,250],"patients":[17,32,74,121,188],"with":[18,33,233,268],"locally":[19],"advanced":[20],"gastric":[21],"cancer":[22],"(LAGC).":[23],"Staging":[24],"laparoscopy":[25],"(SL)":[26],"improves":[27],"staging":[28,86],"accuracy":[29],"redirects":[31],"M1":[35,245],"disease":[36,160,246],"away":[37],"from":[38,131],"futile":[39],"curative":[40,132],"surgery.":[41],"We":[42],"determined":[43],"the":[44,109,139,207,222],"diagnostic":[45],"yield":[46],"SL,":[48],"identified":[49,92,118,242],"independent":[50,93],"predictors":[51,145],"positive":[53],"findings,":[54],"developed":[56,218],"clinical":[58,279],"prediction":[59,97,185,256],"score.":[60],"Methods:":[61],"This":[62,215],"was":[63,99,217],"single-center":[65],"retrospective":[66],"observational":[67],"cohort":[68,224],"study":[69],"113":[71],"consecutive":[72],"LAGC":[73,251],"who":[75],"underwent":[76],"SL":[77,115,241,266],"between":[78],"January":[79],"2023":[80],"December":[82],"2025":[83],"after":[84],"non-metastatic":[85],"on":[87,146],"CT.":[88],"Multivariable":[89],"logistic":[90],"regression":[91],"predictors;":[94],"an":[95],"integer":[96],"score":[98,186,257],"derived":[100],"evaluated":[102,220],"by":[103],"receiver":[104],"operating":[105],"characteristic":[106],"analysis":[107,148],"same":[110,223],"derivation":[111],"cohort.":[112],"Results:":[113],"Positive":[114],"findings":[116],"were":[117,138,149],"27":[120,130],"[23.9%;":[122],"95%":[123,156,163,173,181,212],"confidence":[124],"interval":[125],"(CI):":[126],"16.5\u201332.8%],":[127],"redirecting":[128],"all":[129],"non-curative":[134],"management.":[135],"Peritoneal":[136],"most":[140],"common":[141],"finding":[142],"(15.9%).":[143],"Independent":[144],"multivariable":[147],"CT-detected":[150],"ascites":[151],"[odds":[152],"ratio":[153],"(OR)":[154],"6.84;":[155],"CI:":[157,164,174,182,213],"1.82\u201325.63),":[158],"cT4":[159],"(OR":[161,171,179],"4.12;":[162],"1.65\u201310.31),":[165],"elevated":[166],"serum":[167],"carbohydrate":[168],"antigen":[169],"19-9":[170],"3.21;":[172],"1.24\u20138.29),":[175],"diffuse/signet-ring":[177],"histology":[178],"2.78;":[180],"1.08\u20137.17).":[183],"The":[184,253],"stratified":[187],"into":[189],"low-risk":[190],"(8.2%;":[191],"4/49),":[192],"intermediate-risk":[193],"(22.2%;":[194],"10/45),":[195],"high-risk":[197],"(68.4%;":[198],"13/19)":[199],"groups":[200],"(":[201],"P":[202],"<":[203],"0.001;":[204],"area":[205],"under":[206],"curve":[208],"(AUC)":[209],"=":[210],"0.81;":[211],"0.73\u20130.89).":[214],"model":[216],"without":[225],"internal":[226],"validation;":[227],"performance":[228],"estimates":[229],"should":[230],"be":[231],"interpreted":[232],"caution,":[234],"external":[236],"validation":[237,275],"is":[238,276],"required.":[239],"Conclusion:":[240],"radiologically":[243],"nearly":[248],"one-quarter":[249],"patients.":[252],"proposed":[254],"four-variable":[255],"provides":[258],"practical":[260],"risk-stratification":[261],"framework":[262],"inform":[264],"selective":[265],"utilization,":[267],"particular":[269],"relevance":[270],"resource-constrained":[272],"settings.":[273],"External":[274],"required":[277],"before":[278],"adoption.":[280]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-10T00:00:00"}
