Yasufuku Itaru, Tsuchiya Hiroshi, Fujibayashi Seito, Okumura Naoki, Sengoku Yuki, Fukada Masahiro, Asai Ryuichi, Sato Yuta, Tajima Jesse Yu, Kiyama Shigeru, Kato Takazumi, Tanaka Yoshihiro, Murase Katsutoshi, Matsuhashi Nobuhisa
Department of Clinical Anatomy Development Studies, Gifu University Graduate School of Medicine, Yanagito 1-1, Gifu City 501-1194, Japan.
Department of Gastroenterological and Pediatric Surgery, Gifu University Graduate School of Medicine, Yanagito 1-1, Gifu City 501-1194, Japan.
Cancers (Basel). 2024 Feb 5;16(3):673. doi: 10.3390/cancers16030673.
The concept of oligometastasis is not yet fully established in the field of gastric cancer. However, metastatic lesions that are localized, technically resectable at diagnosis, present a certain response to preoperative chemotherapy, and present favorable survival outcomes with local treatments, sometimes in combination with chemotherapy, are recognized as oligometastasis in the field of gastric cancer. Oligometastasis is noted in European Society for Medical Oncology guidelines and Japanese gastric cancer treatment guidelines, and local treatment is mentioned as one of the pivotal treatment options for oligometastasis. Solitary liver metastasis or a small number of liver metastases; retroperitoneal lymph node metastasis, especially localized para-aortic lymph node metastasis; localized peritoneal dissemination; and Krukenberg tumor are representative types of oligometastasis in gastric cancer. The AIO-FLOT3 trial prospectively evaluated the efficacy of multimodal treatments for gastric cancer with oligometastasis, including surgical resection of primary and metastatic lesions combined with chemotherapy, confirming favorable survival outcomes. Two phase 3 studies are ongoing to investigate the efficacy of surgical resection combined with perioperative chemotherapy compared with palliative chemotherapy. Thus far, the evidence suggests that multimodal treatment for oligometastasis of gastric cancer is promising.
在胃癌领域,寡转移的概念尚未完全确立。然而,那些在诊断时局限、技术上可切除、对术前化疗有一定反应且通过局部治疗(有时联合化疗)可获得良好生存结果的转移病灶,在胃癌领域被视为寡转移。欧洲医学肿瘤学会指南和日本胃癌治疗指南中都提到了寡转移,并且局部治疗被列为寡转移的关键治疗选择之一。孤立性肝转移或少量肝转移;腹膜后淋巴结转移,尤其是局限性腹主动脉旁淋巴结转移;局限性腹膜播散;以及库肯勃瘤是胃癌寡转移的代表性类型。AIO-FLOT3试验前瞻性评估了多模式治疗对寡转移胃癌的疗效,包括对原发灶和转移灶进行手术切除并联合化疗,证实了良好的生存结果。两项3期研究正在进行,以调查手术切除联合围手术期化疗与姑息化疗相比的疗效。到目前为止,证据表明胃癌寡转移的多模式治疗前景良好。