进展期胃癌外科综合治疗的发展趋势

在我国,胃癌仍然是死亡率最高的恶性肿瘤之一,根治性手术是治愈进展期胃癌的唯一手段;D2胃癌根治术作为治疗进展期胃癌的标准术式已被普遍接受.几项临床试验已证实与D2根治术相比,扩大手术范围并未使患者术后生存率有更多的获益.为改善进展期胃癌患者的预后,必须强调开展术前TNM分期,以便临床医生根据肿瘤的状况选择合适的治疗方案.外科综合治疗包括合理应用围手术期化疗、放疗与分子靶向治疗等是治疗进展期胃癌的最佳选择.在本文中,作者介绍了近年来国内外文献报告的有关进展期胃癌外科综合治疗的发展与趋势,供读者借鉴.

Trend of surgical multimodality treatment for advanced gastric cancer

Gastric cancer remains one of the most common causes of cancer-related death in China. Radical operation is the only potentially curative therapy for advanced gastric cancer(AGC). D2 radical gastrectomy has been widely accepted as a standard surgical procedure for patients with AGC in China. Several clinical trials have revealed that more extended resection than D2 surgery has no impact on survival. In order to improve the prognosis of AGC patients, it is necessary to carry out the preoperative TNM staging for selecting a reasonable therapeutical modality before surgery. Multimodality treatment involving perioperative chemotherapy, radiotherapy or molecular targeting agents in addition to surgery have been thought to be promising treatment strategy. In this article, we present an update on the current literature regarding the trends of surgical multimodal treatment for the patients with AGC.