Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
World J Surg Oncol. 2017 Jul 17;15(1):135. doi: 10.1186/s12957-017-1204-6.
Gastric cancer remains a formidable treatment challenge. For decades, treatment consisted mostly of surgical intervention for this deadly disease. With improvements in the multi-disciplinary management of solid organ malignancies, the approach to this disease is being stepwise refined.
One of the prevalent controversies in the surgical management of gastric cancer rests on the need for adequate harvesting of lymph nodes. For decades, lymph node dissection is regarded as a staging technique useful in only upstaging the disease. The adoption of D2 lymphadenectomy has been particularly slow to mature. But with prevailing data from Asia consistently demonstrating a survival benefit from lymphadenectomy, it calls into question the notion of lymphadenectomy as being solely a staging procedure.
As gastric resection techniques are being better defined in western countries and surgical morbidities lowered on its execution, D2 lymphadenectomy is becoming more accepted as the new standard in the management of gastric cancer.
胃癌仍然是一个难以治疗的挑战。几十年来，这种致命疾病的治疗主要是手术干预。随着实体恶性肿瘤多学科管理的改善，这种疾病的治疗方法正在逐步完善。
胃癌手术治疗中一个普遍存在的争议是需要充分采集淋巴结。几十年来，淋巴结清扫被认为是一种分期技术，仅有助于疾病分期。D2 淋巴结清扫术的采用一直比较缓慢。但是，来自亚洲的主流数据持续显示淋巴结清扫术可带来生存获益，这对淋巴结清扫术仅作为分期手术的观点提出了质疑。
随着西方国家胃切除术技术的不断完善和手术并发症的降低，D2 淋巴结清扫术作为胃癌治疗的新标准越来越被接受。
