Irino Tomoyuki, Matsuda Satoru, Wada Norihito, Kawakubo Hirofumi, Kitagawa Yuko
Department of Surgery Keio University School of Medicine Tokyo Japan.
Ann Gastroenterol Surg. 2021 Feb 5;5(2):162-172. doi: 10.1002/ags3.12438. eCollection 2021 Mar.
Perioperative and surgical management of gastric cancer have been changing as pivotal phase II trials and landmark phase III trials offer new insights to the existing knowledge. The results of many landmark trials have been published or presented in the past year, many of which have changed or will change current clinical practice. For example, FLOT4 has completely changed the regimen of perioperative chemotherapy in Europe. Furthermore, evidence for minimally invasive surgery for clinical Stage I was firmly established by KLASS-01 and JCOG0912 for distal gastrectomy and CLASS-02, KLASS-03, and JCOG1401 for total gastrectomy. Moreover, promising results were provided by CLASS-01 and KLASS-02 for locally advanced gastric cancer. For adjuvant chemotherapy, JACCRO GC-07 (START-2) has provided a new doublet regimen for pathological Stage III, which is often refractory to chemotherapy. Conversely, JCOG0501 poses a significant challenge for advanced tumors, such as large type 3 and scirrhous (type 4) tumors. In this review, we briefly review recent updates and discuss future perspectives of gastric cancer treatment.
随着关键的II期试验和具有里程碑意义的III期试验为现有知识带来新的见解，胃癌的围手术期和手术管理一直在发生变化。许多具有里程碑意义的试验结果在过去一年已经发表或公布，其中许多已经或将会改变当前的临床实践。例如，FLOT4试验彻底改变了欧洲围手术期化疗方案。此外，KLASS - 01和JCOG0912试验为远端胃切除术确立了临床I期微创手术的证据，而CLASS - 02、KLASS - 03和JCOG1401试验为全胃切除术确立了该证据。此外，CLASS - 01和KLASS - 02试验为局部晚期胃癌提供了有前景的结果。对于辅助化疗，JACCRO GC - 07（START - 2）试验为病理III期提供了一种新的双联化疗方案，该期通常对化疗耐药。相反，JCOG0501试验对晚期肿瘤，如大的3型和硬癌（4型）肿瘤构成了重大挑战。在本综述中，我们简要回顾近期的进展，并讨论胃癌治疗的未来前景。
