进展期胃癌的外科治疗进展

摘要

胃癌作为高发恶性肿瘤,预后相对乳腺癌、甲状腺癌等其他恶性肿瘤差.目前,外科治疗依然是患者获得临床痊愈的唯一途径.由于其具有较高的淋巴结转移率及复发率等生物学特性,淋巴结清扫在胃癌外科治疗中占有重要地位.此外,尽管腹腔镜手术治疗早期胃癌的安全性和肿瘤学可行性经过前瞻性研究予以证实,但是进展期胃癌的相关治疗模式仍需进一步探究证实.我国半数以上胃癌患者就诊时已发展为进展期,因此进展期胃癌的治疗被广泛关注.一些临床试验显示,腹腔内化疗及热灌注治疗等方式联合手术应用于进展期胃癌取得良好的效果,但仍需大量样本随机对照试验加以证实.%Gastric cancer is a common malignancy with poorer prognosis than other malignancies such as breast cancer and thyroid cancer.The surgical treatment is still the only possible way of cure of the patients.Because of its biological char-acteristics such as high lymph node metastasis and recurrence rate,lymph node dissection plays an important role in surgical treatment of gastric cancer.In addition,although the safety of laparoscopic surgery in the treatment for early gastric cancer and the feasibility of oncology are confirmed by prospective studies,the related modalities for advanced gastric cancer need to be further confirmed.More than half of gastric cancer patients in China have been in developing stage at the time of treat -ment.Therefore,the treatment of advanced gastric cancer has been widely concerned.Some clinical trials have shown that combined intraperitoneal chemotherapy and thermal perfusion therapy have achieved good results in advanced gastric cancer,but a large number of samples are still required for randomized controlled trials for confirmation.