2014年第4版日本《胃癌治疗指南》更新要旨

2010年第3版日本《胃癌治疗指南》（以下为“指南”）发行以来,对胃癌外科治疗产生了巨大影响,胃癌治疗更为标准化、合理化、规范化。近年来,新的科学研究成果的问世,两次促使“指南”修订、再版。2014年第4版“指南”在原来的基础上,对7个大的问题进行了修订,引进了新的证据和标准（更新胃手术的定义;制定食管胃结合部癌＜4 cm时淋巴结清扫的暂行规定和流程图;确定Ⅰ期胃癌腹腔镜下远端胃切除术为常规性治疗;胃镜下治疗的相关标准;化疗方案推荐度;HER2阴性、阳性胃癌的推荐方案、流程图;M1胃癌的手术、化疗问题以及术后随访的相关规定）。第4版“指南”汲取了最新的科学成就,将胃癌治疗的基本原则、概念更为科学化、精准化,为今后的临床实践提供了重要的指导作用。

Japanese gastric cancer treatment guidelines-the 4th Edition 2014 update message

Japanese gastric cancer treatment guidelines-the 4th Edition 2014 update message        HU Xiang. Department of General Surgery,the First Affiliated Hospital,Dalian Medical University,Dalian 116011,China
Abstract    The launch of Japanese gastric cancer treatment guidelines ( the following as guide) -the 3rd Edition in 2010 has produced a great effect on the surgical treatment of gastric cancer. The treatment of gastric cancer is more standardized, rationalized and normalized. In recent years, new research results made "guide" revised and reedited. In the new "guide" of the 4th Edition 2014, seven major problems were revised on the basis of the previous “guide”. New evidence and standards were introduced (the definition of gastric operation was updated; temporary provisions and flow chart were enacted for the lymph node dissection when the size of esogastric junction adenocarcinoma is smaller than 4cm; laparoscopic distal gastrectomy was considered to be the conventional treatment for stage I gastric cancer; the relevant standards under gastroscope therapy; the recommended degree of chemotherapy ; the recommended scheme and flow chart for HER2-negative and HER2-positive gastric carcinoma; the relevant provisions of the operation, chemotherapy and follow-up for gastric cancer of stage M1). The "guide"- the 4th edition  has acquired the latest scientific achievements, which makes the basic principles for the treatment of gastric cancer and the concept more scientific and accurate. It will provide important guidance for the future clinical practice.