Hu Xiang
Department of General Surgery, Dalian Medical University, Dalian , China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Feb;15(2):113-5.
The Japanese Gastric Cancer Treatment Guidelines (the Guidelines), as a guiding and programmatic document in the treatment for gastric cancer, has drawn high attention worldwide. The treatment selection and determination is mainly based on the T staging. Endoscopic therapy, laparoscopic surgery and minimal extent surgery have consisted of the main clinical practice for T1 cancer. D2 dissection is a standard procedure for advanced cancer(T2-T4). Extensive resection or neoadjuvant preoperative chemotherapy is recommended for highly advanced cancer. Progress in gastric cancer treatment has been acquired recently due to high-level clinical trials, new anti-cancer drugs application, and efficiency of chemotherapy. Therefore, traditional extensive resection has been abandoned gradually. Comprehensive treatment based on chemotherapy could improve survival for patients with unresectable and recurrent gastric cancer.
《日本胃癌治疗指南》（以下简称《指南》）作为胃癌治疗的指导性纲领性文件，在全球范围内受到高度关注。治疗方案的选择和确定主要基于T分期。内镜治疗、腹腔镜手术和缩小范围手术构成了T1期胃癌的主要临床实践。D2根治术是进展期胃癌（T2 - T4）的标准术式。对于高度进展期胃癌，建议行扩大切除或新辅助术前化疗。近年来，由于高水平临床试验、新型抗癌药物的应用以及化疗效果，胃癌治疗取得了进展。因此，传统的扩大切除术已逐渐被摒弃。基于化疗的综合治疗可提高不可切除及复发性胃癌患者的生存率。
