Fornaro Lorenzo, Spallanzani Andrea, de Vita Ferdinando, D'Ugo Domenico, Falcone Alfredo, Lorenzon Laura, Tirino Giuseppe, Cascinu Stefano
Department of Translational Medicine, Division of Medical Oncology, AOU Pisana, 56126 Pisa, Italy.
Department of Oncology and Hematology, University Hospital of Modena, 41125 Modena, Italy.
Cancers (Basel). 2021 Mar 15;13(6):1304. doi: 10.3390/cancers13061304.
Management of gastric and gastroesophageal junction (GEJ) adenocarcinoma remains challenging, because of the heterogeneity in tumor biology within the upper gastrointestinal tract. Daily clinical practice is full of grey areas regarding the complexity of diagnostic, staging, and therapeutic procedures. The aim of this paper is to provide a guide for clinicians facing challenging situations in routine practice, taking a multidisciplinary consensus approach based on available literature.
The GAIN (GAstric cancer Italian Network) group was established with the aims of reviewing literature evidence, discussing key issues in prevention, diagnosis, and management of gastric and GEJ adenocarcinoma, and offering a summary of statements. A Delphi consensus method was used to obtain opinions from the expert panel of specialists.
Forty-nine clinical questions were identified in six areas of interest: role of multidisciplinary team; risk factors; diagnosis; management of early gastric cancer and multimodal approach to localized gastric cancer; treatment of elderly patients with locally advanced resectable disease; and treatment of locally advanced and metastatic cancer.
The statements presented may guide clinicians in practical management of this disease.
由于上消化道肿瘤生物学的异质性，胃及胃食管交界（GEJ）腺癌的管理仍然具有挑战性。日常临床实践中，在诊断、分期和治疗程序的复杂性方面存在诸多灰色地带。本文旨在基于现有文献，采用多学科共识方法，为日常实践中面临挑战性情况的临床医生提供指导。
成立了GAIN（意大利胃癌网络）小组，旨在回顾文献证据，讨论胃及GEJ腺癌预防、诊断和管理中的关键问题，并提供声明总结。采用德尔菲共识方法征求专家小组的意见。
在六个感兴趣的领域确定了49个临床问题：多学科团队的作用；危险因素；诊断；早期胃癌的管理及局限性胃癌的多模式方法；老年局部晚期可切除疾病患者的治疗；以及局部晚期和转移性癌症的治疗。
所提出的声明可为临床医生对该疾病的实际管理提供指导。
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