进展期胃癌围手术期治疗的探索与思考

进展期胃癌患者的围手术期治疗是提高胃癌整体疗效、改善预后的重要环节。可切除胃癌围手术期治疗的主要模式为D 1/D 2手术+围手术期化疗、D 0/D 1手术+辅助放化疗和D 2手术+辅助化疗。多年来，业内围绕如何进一步优化胃癌围手术期治疗模式开展了大量临床研究，包括术后放...

Exploration and thoughts on perioperative treatment of advanced gastric cancer

Perioperative treatment is critical to improve the outcomes of patients with advanced gastric cancer.There are three therapeutic modes of perioperative treatment for resectable gastric cancer:neoadjuvant chemotherapy+D1/D2 surgery+adjuvant chemotherapy,D0/D1 surgery+adjuvant radiochemotherapy,and D2 surgery+adjuvant chemotherapy.Over the decades,a large number of clinical studies had been conducted to optimize the perioperative treatment mode of gastric cancer,including the postoperative radiotherapy and chemotherapy,and perioperative chemotherapy,and to explore the feasibility of preoperative radiochemotherapy,targeted therapy,and immunotherapy in advanced gastric cancer.After nearly 20 years of development and exploration,although the perioperative treatment mode for advanced gastric cancer has become standardized,there are still some core issues that need to be solved urgently,including the selection of population for perioperative treatment,the limitation of efficaly evaluation criteria,insufficient emphasis on laparoscopic exploration before neoadjuvant treatment,and lack of exploration in esophagogastric junction cancer.We should fully integrate the current clinical research data into clinical practice,adopt a multidisciplinary diagnosis and treatment mode,and follow the principles of standardized diagnosis and treatment based on a multi-dimensional analysis of patient characteristics,and formulate the most reasonable treatment strategy to ultimately benefit patients.