Prognostic role of peritoneal cytological status in the staging of gastric cancer - an unsettled discussion

Background: Staging laparoscopy is recommended for patients with stage IB-III resectable gastric cancer to exclude radiologically occult metastatic disease, especially involving the peritoneum/diaphragm. Results of cytological examination of peritoneal lavage fluid are generally considered important predictors of survival, though some studies have failed to show an association between positive peritoneal cytology and recurrence-free or overall survival. Furthermore, there is still disagreement over how patients with positive cytology should be managed.