进一步认识和提高进展期胃癌综合治疗的理念

胃癌是我国最常见的恶性肿瘤之一,其发病率和死亡率一直居高不下.目前,根治性手术仍然是治疗进展期胃癌的重要基石,但已非唯一手段.为进一步改善预后,需要外科医师重视和提高综合治疗的理念：必须强调开展准确的术前TNM分期,以选择恰当的治疗模式;在规范化手术的基础上合理运用化疗、放疗和分子生物靶向治疗等综合手段,以较小的代价换取最佳的肿瘤预后;对晚期转移性患者不轻言放弃,制定个体化治疗方案以延长生存期并提高生活质量.此外,应充分认识到胃癌的异质性,科学看待东西方人种胃癌生物学行为的差异,在治疗上加强多学科协作,以实现规范化和个体化相融的综合治疗模式,使患者获益.

Further recognition and improvement of multimodality treatment for advanced gastric cancer

Gastric cancer is one of the most common malignancies in China,which remains in high incidence and mortality.At present,radical surgery remains the cornerstone of multidisciplinary treatment in advanced gastric cancer,but is not the only one.In order to improve prognosis,it is necessary for surgeons to realize and emphasize the idea of comprehensive treatment.Accurate preoperative TNM staging is a prerequisite for selecting reasonable therapeutic modality.Based on standard surgery,multimodal treatments involving （neo-） adjuvant chemotherapy,radiotherapy or molecular target agents still need to be optimized for the best oncologic outcome with minimal morbidities.As to metastatic and late cases,personalized strategy is being acknowledged to prolong survival time and improve quality of life.A deeper understanding of high heterogeneity and biological characteristics of gastric cancer should be carried out,and multidisciplinary team collaboration is quite important to achieve an optimal treatment mode both standardized and individualized,which will benefit every patient.