Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Surg Oncol. 2012 Jun;21(2):119-23. doi: 10.1016/j.suronc.2010.12.004. Epub 2011 Jan 21.
Gastric cancer ranks the second leading cause of cancer-specific mortality worldwide. With a poor prognosis, 5-year survival rate of gastric cancer is less than 20%-25% in the USA, Europe, and China [1]. However, early gastric cancer(EGC) offers an excellent (over 90%) chance of cure based on surgical resection [2]. As the increasing detection of EGC, more treatment options have been developed both curatively and minimally invasively to maintain a good quality of life(QOL). One of the advanced therapeutic techniques is endoscopic dissection. Improvements in surgical treatment include minimizing lymph node dissection, reconstruction methods, laparoscopy-assisted surgery, and sentinel node navigation surgery(SNNS) [3]. With technological advances, even Natural Orifice Transluminal Endoscopy Surgery (NOTES) and robotic surgery are expected to represent the next revolution [4]. However, there still remains much dispute among these treatments, which arouses further clinical trials to verify. Update of the treatments, controversial indications, prognosis and current strategies for EGC are discussed in this review.
胃癌是全球癌症特异性死亡的第二大主要原因。在美国、欧洲和中国，胃癌的预后较差，5 年生存率低于 20%-25%[1]。然而，早期胃癌（EGC）基于手术切除可提供极好的（超过 90%）治愈机会[2]。随着 EGC 的检出率不断增加，已经开发出更多的治疗方法，包括治愈性和微创性方法，以维持良好的生活质量（QOL）。内镜下剥离术是一种先进的治疗技术。手术治疗的改进包括尽量减少淋巴结清扫、重建方法、腹腔镜辅助手术和前哨淋巴结导航手术（SNNS）[3]。随着技术的进步，甚至经自然腔道内镜手术（NOTES）和机器人手术也有望带来下一次革命[4]。然而，这些治疗方法仍存在许多争议，需要进一步的临床试验来验证。本综述讨论了 EGC 的治疗更新、有争议的适应证、预后和当前策略。
