基于日本胃癌治疗指南T分类的胃癌外科治疗

日本《胃癌治疗指南》（“指南”）作为胃癌治疗中确定治疗方针的指导性、纲领性文件,受到世界各国的关注.“指南”中治疗方针的选择和确定是以T分类为基准进行的.T1的治疗方针主要是内镜下、腹腔镜下手术和缩小手术为主,T2～T4的进展期胃癌治疗的基本方针是标准D2手术为基本选择,高度进展期胃癌则采取扩大手术和术前辅助化疗.以往扩大手术为主流的治疗,由于近年“高级别”临床研究成果的出现、新型抗癌药物的问世以及手术前后辅助化疗的有效性,为临床提供了更为有效的多种治疗方法.对于不能切除及复发性的胃癌,目前以化疗为中心的综合治疗能获取延长寿命的效果.

Surgical treatment for gastric cancer based on T staging according to Gastric Cancer Treatment Guidelines

The Japanese Gastric Cancer Treatment Guidelines (the Guidelines), as a guiding and programmatic document in the treatment for gastric cancer, has drawn high attention worldwide. The treatment selection and determination is mainly based on the T staging. Endoscopic therapy, laparoscopic surgery and minimal extent surgery have consisted of the main clinical practice for T1 cancer. D2 dissection is a standard procedure for advanced cancer(T2-T4). Extensive resection or neoadjuvant preoperative chemotherapy is recommended for highly advanced cancer. Progress in gastric cancer treatment has been acquired recently due to high-level clinical trials, new anti-cancer drugs application, and efficiency of chemotherapy. Therefore, traditional extensive resection has been abandoned gradually. Comprehensive treatment based on chemotherapy could improve survival for patients with unresectable and recurrent gastric cancer.