胃癌的术前分期及术后监测

Preoperative staging and postoperative surveillance for gastric cancer.

作者信息

Jensen Eric H, Tuttle Todd M

机构信息

Division of Surgical Oncology, University of Minnesota Medical Center, MMC 195, 420 Delaware Street SE, Minneapolis, MN 55455, USA.

出版信息

Surg Oncol Clin N Am. 2007 Apr;16(2):329-42. doi: 10.1016/j.soc.2007.03.003.

DOI:10.1016/j.soc.2007.03.003

PMID:17560516

Abstract

Physicians must consider multiple factors when determining the most appropriate preoperative imaging strategy for gastric cancer. Health care resources are not unlimited, and the use of multiple expensive imaging techniques that do not alter treatment decisions is not recommended. With this in mind, EGD and CT scan alone should form the basis for preoperative evaluation, with further imaging considered only in selected cases. Based on the reviewed literature, we do not recommend routine surveillance imaging after curative surgery for gastric cancer. We agree with current NCCN guidelines that recommend history and physical examination every 4 to 6 months for 3 years, followed by yearly examinations. Imaging studies and endoscopy should be selectively performed in symptomatic patients.

摘要

在确定胃癌最合适的术前成像策略时，医生必须考虑多个因素。医疗资源并非无限，不建议使用多种不会改变治疗决策的昂贵成像技术。考虑到这一点，仅内镜检查（EGD）和CT扫描应作为术前评估的基础，仅在特定病例中考虑进一步成像。根据所审查的文献，我们不建议对胃癌根治性手术后进行常规监测成像。我们同意美国国立综合癌症网络（NCCN）目前的指南，即建议在3年内每4至6个月进行一次病史和体格检查，随后每年进行一次检查。有症状的患者应选择性地进行影像学检查和内镜检查。