1st Surgical Division, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2010 Apr;14(4):315-9.
Gastric carcinoma is one of the most frequent malignancies in the world and its clinical behavior depends on the metastatic potential of the tumour. Particularly, lymphatic metastasis is one of the main predictor of tumour recurrence and survival and current pathologic staging systems reflect the concept that lymphatic spread is the most relevant prognostic factor in patients resected with curative intent. This is deducted by the observation that two thirds of gastric cancers in the western world present at an advanced stage, with nearly 85% of tumors accompanied by lymph node metastasis at diagnosis. To date most therapeutic efforts are directed toward individualization of therapeutic protocols, tailoring the extent of resection integrated by the administration of preoperative and postoperative treatment. The goal of such strategies is to improve prognosis towards the achievement of a curative resection (R0-resection) with minimal morbidity and mortality, with better postoperative quality of life. A brief review of literature about preoperative therapy for gastric carcinoma will be herein illustrated. The rationale and the general drawbacks of preoperative treatments will be both discussed in order to demonstrate its value in terms of safety and efficacy.
胃癌是世界上最常见的恶性肿瘤之一，其临床行为取决于肿瘤的转移潜能。特别是，淋巴转移是肿瘤复发和生存的主要预测因素之一，目前的病理分期系统反映了这样一种概念，即对于有治愈意图进行切除的患者，淋巴扩散是最相关的预后因素。这可以从观察到的结果中推断出来，即在西方世界，三分之二的胃癌处于晚期，近 85%的肿瘤在诊断时伴有淋巴结转移。迄今为止，大多数治疗努力都集中在治疗方案的个体化上，通过术前和术后治疗来调整切除的范围。这些策略的目标是改善预后，实现根治性切除（R0 切除），同时最大限度地降低发病率和死亡率，并提高术后生活质量。本文将简要综述胃癌的术前治疗。将讨论术前治疗的原理和一般缺点，以证明其在安全性和疗效方面的价值。
