Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina.
Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
Updates Surg. 2023 Oct;75(7):1751-1758. doi: 10.1007/s13304-023-01576-7. Epub 2023 Jun 26.
Gastric cancer remains the 5th most common cancer and the 3rd most common cause of cancer mortality. Most patients diagnosed with gastric cancer still have a poor prognosis due to its advanced presentation at diagnosis, even in countries with developed screening programs. Surgery is the cornerstone of the treatment for gastric cancer, often combined with perioperative chemotherapy. Lymph node dissection is a crucial component of the surgical treatment of gastric cancer. D1 lymphadenectomy is currently recommended for early stage tumors. The extent of lymphadenectomy in advanced gastric cancer, however, is still a matter of debate between Eastern and Western surgeons. Although a D2 dissection is the current standard recommended by most guidelines, there might be a place for more limited dissections such as D1 + in selected cases. This evidence-based review will help defining the optimal lymphadenectomy for patients with gastric cancer.
胃癌仍然是第五大常见癌症和第三大癌症死亡原因。即使在有发达筛查计划的国家，大多数被诊断出患有胃癌的患者由于其在诊断时已处于晚期，预后仍然较差。手术是胃癌治疗的基石，通常与围手术期化疗联合使用。淋巴结清扫是胃癌手术治疗的重要组成部分。D1 淋巴结清扫术目前推荐用于早期肿瘤。然而，在东西方外科医生之间，对于晚期胃癌的淋巴结清扫范围仍存在争议。尽管大多数指南目前推荐 D2 解剖，但在某些情况下，如在选定病例中进行 D1+更有限的解剖，可能有其存在的空间。本循证综述将有助于为胃癌患者确定最佳的淋巴结清扫范围。
