Karakas E, Oetzmann von Sochaczewski C, Haist T, Pauthner M, Lorenz D
Klinik für Allgemein- und Viszeralchirurgie, Dr. Horst-Schmidt Klinik, Ludwig-Erhard Str. 100, 65199, Wiesbaden, Deutschland.
Chirurg. 2014 Mar;85(3):186-91. doi: 10.1007/s00104-013-2598-5.
Cancer of the upper gastrointestinal tract is one of the leading causes for cancer related deaths worldwide. While the incidence of esophageal carcinoma is increasing, the incidence of gastric cancer has been continuously decreasing over the past decades. Most patients are often diagnosed with advanced stage disease and the prognosis is still dismal. For many patients surgery is the central part of the therapy; however, improvements in the diagnostic work-up, staging techniques and therapy concepts have led to a more individualized therapeutic approach. Endoscopic treatment of early cancer is well established with high cure rates. In advanced gastric cancer the implementation of multimodal therapies, standardized surgical techniques and optimized perioperative management has led to an improvement in prognosis and outcome. The limitations of surgery in esophagogastric cancer are defined by current scientific results, recent technical developments and patient-specific characteristics. These limitations are continuously changing and require an ongoing review.
上消化道癌是全球癌症相关死亡的主要原因之一。虽然食管癌的发病率在上升，但在过去几十年中，胃癌的发病率一直在持续下降。大多数患者往往在疾病晚期才被诊断出来，预后仍然很差。对许多患者来说，手术是治疗的核心部分；然而，诊断检查、分期技术和治疗理念的改进导致了更个体化的治疗方法。早期癌症的内镜治疗已得到充分确立，治愈率很高。在晚期胃癌中，多模式治疗、标准化手术技术和优化的围手术期管理的实施已使预后和结果得到改善。食管癌和胃癌手术的局限性由当前的科学成果、近期的技术发展和患者的特定特征所决定。这些局限性在不断变化，需要持续进行评估。
