胃肠道癌腹膜转移的化疗策略

腹膜转移是严重影响胃肠道癌患者预后的独立不良因素，"种子-土壤"学说被认为是解释腹膜转移的主要理论。由于腹膜转移结节初发时体积小，早期诊断尤为困难，因此，腹膜转移的风险评估就显得尤为重要。目前诊断方法已由临床病理因素逐渐向细胞学、乃至分子层面纵深发展，而包括影像组学在内的多组学整合评估，也进一步丰富了腹膜转移的精准诊断...

Strategies of chemotherapy for peritoneal metastasis of gastrointestinal cancer

Peritoneal metastasis of gastrointestinal cancer is an independent factor that seriously affects the prognosis of patients.The"seed-soil"theory is considered to be the main theory to explain peritoneal metastasis.Because of the small size of peritoneal metastatic nodules at the initial stage,early diagnosis is particularly difficult,therefore,the risk assessment of peritoneal metastasis is very important.Recently,the diagnosis methods have gradually developed from clinicopathological factors to cytology and molecular level.In addition,the integrated assessment of multiple groups including radiomics further enriches the accurate diagnosis of peritoneal metastasis.Peritoneal metastasis is a big challenge in the treatment of gastrointestinal cancer which may also lead to refractory malignant ascites,intestinal obstruction,cachexia and other related complications.At present,the treatment is based on systemic chemotherapy.The combination of surgery,intraperitoneal chemotherapy and HIPEC is an effective treatment for peritoneal metastasis of gastrointestinal cancer.How to enrich peritoneal metastasis patients with potential benefits,how to determine the timing of conversion surgery,how to further optimize the existing treatment plan,especially how to formulate treatment plan for patients after conversion surgery,call for improved study design and prospective randomized controlled trials.The goal of continuous efforts is to effectively prolong the survival of gastrointestinal cancer trials patients with peritoneal metastasis.