Gastric cancer.
Gastric cancer.
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DOI：
10.1016/s0140-6736(09)60617-6
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发表时间：
2009-08-08
期刊：
影响因子：
--
通讯作者：
van de Velde CJ
中科院分区：
文献类型：
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作者：
Hartgrink HH;Jansen EP;van Grieken NC;van de Velde CJ
胃癌是全球第二常见的癌症死亡原因，尽管发病率存在很大的地域差异。预防和个体化治疗被认为是降低胃癌死亡率的最佳选择。预防策略应基于特定的风险特征，包括幽门螺杆菌的基因型、宿主基因多态性、前驱病变的存在和环境因素。尽管适当的手术仍然是胃癌治疗的基石，但这种单一的治疗方法似乎已经达到了局部控制和生存的最大效果。微创技术可用于早期胃癌的治疗。实现对晚期疾病的局部区域控制仍然非常困难。扩大切除在一些亚洲国家是标准做法，但在其他发达国家并没有显示出同样有效。我们介绍了胃癌的发病率、病因、病理和治疗的最新进展，包括手术、新辅助和辅助化疗或放射治疗的新策略，或两者兼而有之，使用基因标记的新治疗策略，以及病例量对患者预后的影响。
Gastric cancer is the second most frequent cause of cancer death worldwide, although much geographical variation in incidence exists. Prevention and personalised treatment are regarded as the best options to reduce gastric cancer mortality rates. Prevention strategies should be based on specific risk profiles, including Helicobacter pylori genotype, host gene polymorphisms, presence of precursor lesions, and environmental factors. Although adequate surgery remains the cornerstone of gastric cancer treatment, this single modality treatment seems to have reached its maximum achievable effect for local control and survival. Minimally invasive techniques can be used for treatment of early gastric cancers. Achievement of locoregional control for advanced disease remains very difficult. Extended resections that are standard practice in some Asian countries have not been shown to be as effective in other developed countries. We present an update of the incidence, causes, pathology, and treatment of gastric cancer, consisting of surgery, new strategies with neoadjuvant and adjuvant chemotherapy or radiotherapy, or both, novel treatment strategies using gene signatures, and the effect of caseload on patient outcomes.