Tumor Staging

Determination of the tumor stage (tumor staging): Once the diagnosis of gastric cancer is confirmed, the tumor stage is then determined in order to plan the further therapeutic procedure. Various methods are used to assess the spread of the tumor, lymph node involvement and possible distant metastases.
Chest x-ray (chest x-ray): A chest x-ray (chest x-ray) can provide information about the infestation of the lungs and the mediastinal lymph nodes in the mediastinum.
Ultrasound (endosonography (endoluminal ultrasound)): In endosonography, the patient first has to “swallow” a tube, as in gastroscopy, during a light anaesthetic. However, during this examination, an ultrasound probe is attached to the end of the tube instead of the camera.
With this method, by placing the ultrasound probe on the tumor, its spread into the depths (infiltration), i.e. into the stomach wall, can be made visible and (regional) lymph nodes located in the stomach area can also be assessed.
Computed tomography (CT): Spiral computed tomography (spiral CT) can provide information about the extent of the tumor, the spatial relationship to neighboring organs, lymph node involvement and, in addition, distant metastases. A CT scan of both the thorax and the abdomen is required to assess all metastatic pathways. Magnetic resonance imaging (MRT) provides similar results.During the course of the disease, a CT or MRI of the skull may also be necessary to diagnose brain metastases.
Sonography: With sonography (ultrasound), the abdominal organs are assessed non-invasively and without radiation exposure.
Sonography of the abdominal cavity (abdomen) can reveal metastases in the liver or affected lymph nodes, for example. Since the method is easy to use and not harmful to the patient, it can be repeated many times without hesitation and can be used for follow-up and aftercare.
Skeletal scintigraphy: Skeletal scintigraphy is a nuclear medical imaging examination and is used during tumor staging to detect distant metastases in the skeleton. For this purpose, a radioactively marked substance is administered intravenously to the patient and then the distribution of the radioactive substance in the bone is visualized with a special camera (gamma camera).
The radioactive substances accumulate in the bone and can be found increased where bone remodeling and repair processes are underway. Thus, an accumulation of radioactive substance can be detected in the area of bone metastases.
Laparoscopy: In advanced stages of tumors, it is sometimes necessary to perform a laparoscopy in order to correctly assess the regional extent and possible involvement of the peritoneum (peritoneal cancer) and the liver (metastases). During this procedure, which is performed under general anesthesia, various instruments and a camera can be inserted through small incisions in the abdominal skin, allowing the tumor spread to be viewed directly.