Staging laparoscopy reveals peritoneal disease in over half of advanced gastric cancer patients, enhancing surgical decision-making.

• Peritoneal disease was found in 54.9% of patients undergoing staging laparoscopy, with positivity rates of 61.7% in type 4 lesions.
• The sensitivity and specificity of staging laparoscopy were 94.6% and 100%, respectively, demonstrating high diagnostic accuracy.

The four-factor predictive score aids in patient selection, increasing the potential to tailor surgical interventions based on individual risk.

• Risk factors include elevated CA19-9 and CA125 levels and specific tumor histologies, with disease incidence ranging from 32.4% to 100% based on score.