Chevallay Mickael, Wassmer Charles-Henri, Iranmanesh Pouya, Jung Minoa K, Mönig Stefan P
Division of Digestive Surgery, Geneva University Hospital and Faculty of Medicine, Geneva 1205, Genève, Switzerland.
World J Gastrointest Oncol. 2022 Feb 15;14(2):434-449. doi: 10.4251/wjgo.v14.i2.434.
Gastric cancer is generally diagnosed at an advanced stage, especially in countries without screening programs. Previously, the metastatic stage was synonymous with palliative management, and surgical indications were only for symptomatic relief. However, this therapeutic option is associated with poor prognosis. A subgroup of patients with limited metastatic disease could benefit from intensive treatment. A combination of chemotherapy, immunotherapy, and targeted therapy could help either maintain a resectable state for oligometastatic disease or diminish the metastasis size to obtain a complete resection configuration. This latter strategy is known as conversion therapy and has growing evidence with favorable outcomes. Oncosurgical approach of metastatic disease could prolong survival in selected patients. The challenge for the surgeon and oncologist is to identify these specific patients to offer the best multimodal management. We review in this article the actual evidence for the treatment of oligometastatic gastric cancer with curative intent.
胃癌通常在晚期才被诊断出来,尤其是在没有筛查项目的国家。以前,转移阶段等同于姑息治疗,手术指征仅用于缓解症状。然而,这种治疗选择预后较差。一小部分转移病灶有限的患者可能从强化治疗中获益。化疗、免疫治疗和靶向治疗的联合应用可以帮助维持寡转移病灶的可切除状态,或者缩小转移灶大小以实现完全切除。后一种策略被称为转化治疗,越来越多的证据表明其疗效良好。转移性疾病的肿瘤外科治疗方法可以延长部分患者的生存期。外科医生和肿瘤学家面临的挑战是识别这些特定患者,以便提供最佳的多模式治疗。我们在本文中综述了以治愈为目的治疗寡转移胃癌的现有证据。
World J Gastrointest Oncol. 2022-2-15
Zhonghua Wei Chang Wai Ke Za Zhi. 2018-10-25
Eur Urol Oncol. 2018-10-9
World J Gastrointest Oncol. 2018-11-15
Ann Palliat Med. 2021-5
Indian J Med Res. 2021-8
Transl Gastroenterol Hepatol. 2017-5-26
Cancers (Basel). 2022-10-23
Ann Thorac Surg. 2016-10
BMC Cancer. 2020-3-30
Innov Surg Sci. 2024-8-2
Arq Bras Cir Dig. 2023
Expert Opin Biol Ther. 2021-7
N Engl J Med. 2020-5-29
Gastric Cancer. 2021-1
Gastroenterology. 2020-2