Department of Surgery, Klinikum rechts der Isar der Technischen Universitaet Muenchen, Muenchen, Germany. ; Diakonie Klinikum Stuttgart, Stuttgart, Germany.
J Gastric Cancer. 2013 Jun;13(2):73-8. doi: 10.5230/jgc.2013.13.2.73. Epub 2013 Jun 25.
Surgery is still considered to be the mainstay for the treatment of localized gastric cancer with negative margins (R0-resection) and an adequate lymph-node-dissection (D2-lymphadenectomy). Unfortunately, most cases of gastric cancer are only diagnosed at an advanced stage due to frequent recurrences after primary resection in curative intent. In order to improve prognosis after curative resection, in the recent past, patients with locally advanced tumors were subjected to a pre-, peri-, or postoperative treatment. Interestingly, postoperative chemotherapy has significantly improved survival after gastric resection in Asia, adjuvant radiochemotherapy is favored in North America and perioperative chemotherapy is considered as a treatment of choice in Europe indicating region specific approach towards the treatment. Recently there has also been growing evidence of positive outcomes of neoadjuvant radiochemotherapy on patient survival. In the present article, we discuss the concepts of neoadjuvant treatment approach and provide recommendations to surgeons based on current evidence.
手术仍然被认为是治疗局部胃癌的主要方法，其要求为阴性切缘（R0 切除）和足够的淋巴结清扫（D2 淋巴结清扫）。不幸的是，由于在根治性切除术后经常复发，大多数胃癌病例仅在晚期被诊断出来。为了提高根治性切除术后的预后，在最近的一段时间里，局部进展期肿瘤患者接受了术前、术中和术后治疗。有趣的是，术后化疗显著改善了亚洲地区胃癌切除术后的生存率，辅助放化疗在北美受到青睐，而围手术期化疗被认为是欧洲的首选治疗方法，这表明针对治疗存在区域性差异。最近也有越来越多的证据表明新辅助放化疗对患者生存有积极影响。在本文中，我们讨论了新辅助治疗方法的概念，并根据现有证据向外科医生提供了建议。
