中国实用外科杂志2017，Vol.37Issue(10)：1073-1077,1082,6.DOI:10.19538/j.cjps.issn1005-2208.2017.10.02
晚期胃癌手术治疗价值及合理应用
Value and reasonable selection of surgery in advanced gastric cancer
摘要
Abstract
Advanced gastric cancer has poor prognosis.Chemotherapy or with targeted drug is the primary treatment.Retrospective studies implied that surgery could relieve emergencies such as bleeding and obstruction,as well as improve survival for selected patients.In addition,the progress of drug therapy gave birth to the concept of conversion therapy,which further affirmed the value of surgery in advanced gastric cancer.However,it is still lack of evidence in the choice of surgical group,surgery opportunity,operation scope and postoperative treatment.Based on the advanced gastric cancer classification proposed by the authors' center,every patient should be discussed through MDT.For resectable tumor with less burden,the principle resembles neoadjuvant chemotherapy and the surgery aims at R0.For unresectable tumor with more burden,surgery is only conducted in patients after effective systemic therapy,and the ideal surgery should be performed after effective treatment and also before drug resistance.The operation scope should also consider the complication and slow postoperative recovery which possibly delay or interrupt systemic treatment.Postoperative systemic treatment should be considered.However,systemic treatment is still the cornerstone of advanced gastric cancer.Surgery should still be performed cautiously in highly selected patients before more solid evidence existed.The treatment effect depends on further exploration of effective drugs and genotyping markers.关键词
晚期胃癌/手术/转化治疗Key words
advanced gastric cancer/surgery/conversion therapy分类
医药卫生引用本文复制引用
李子禹,薛侃,季加孚..晚期胃癌手术治疗价值及合理应用[J].中国实用外科杂志,2017,37(10):1073-1077,1082,6.基金项目
科技部支撑计划(No.2014BAI09B02) （No.2014BAI09B02）
国家自然科学基金(No.81374016) （No.81374016）
