Mastoraki Sotiria, Mastoraki Aikaterini, Lefantzis Nikolaos, Safioleas Panagiotis, Sakorafas George, Safioleas Michael
Indian J Surg. 2011 Aug;73(4):251-5. doi: 10.1007/s12262-011-0285-7. Epub 2011 Apr 21.
Gastric cancer is still the fourth common neoplasm worldwide. Gastric ulcers, adenomatous polyps, and intestinal metaplasia have been associated with an increased relative risk. Tissue diagnosis and anatomic localization of the primary tumor are best obtained by upper gastrointestinal endoscopy. Despite new screening techniques peritoneal tumor spread and occult liver and lymph node metastases are only detected intra-operatively. Therapy is becoming more and more complex comprising surgical resection, investigational neoadjuvant, adjuvant or palliative chemotherapy, or supportive care. Complete surgical eradication of a tumor with resection of adjacent lymph nodes represents the best chance for long-term survival. The choice of operation depends upon the location of the tumor, the clinical stage, and the histologic type. Chemotherapy can provide symptom palliation, improve quality of life, and prolong survival in patients with advanced gastric cancer. Preoperative radiation therapy may allow for tumor downstaging and reduced probability of residual microscopic disease at surgery.
胃癌仍是全球第四大常见肿瘤。胃溃疡、腺瘤性息肉和肠化生与相对风险增加有关。原发性肿瘤的组织诊断和解剖定位最好通过上消化道内镜检查获得。尽管有新的筛查技术，但腹膜肿瘤播散以及隐匿性肝和淋巴结转移仅在手术中才能检测到。治疗正变得越来越复杂，包括手术切除、试验性新辅助化疗、辅助化疗或姑息化疗，或支持治疗。通过切除相邻淋巴结完全手术根除肿瘤是长期生存的最佳机会。手术方式的选择取决于肿瘤的位置、临床分期和组织学类型。化疗可以缓解症状、改善生活质量并延长晚期胃癌患者的生存期。术前放疗可能会使肿瘤降期，并降低手术时残留微小疾病的可能性。
