打好晚期胃癌诊疗“组合拳”

Play the"combo fist"in the diagnosis and treatment of advanced gastric cancer

胃癌发病率位居世界恶性肿瘤榜第5位,死亡率为第4位,其在我国的突出特点是中晚期患者占比较高,其中又有约40%的患者处于晚期阶段。晚期胃癌预后较差,平均生存时间约1年。对于晚期胃癌,其诊断方式(腹腔镜探查、分子图谱、人工智能)仍在不断完善,而治疗仍以化疗为主。随着医学日新月异的发展,外科手术在晚期胃癌中的作用日益凸显。因此,作为胃肿瘤外科医生,应思考如何根据不同的病理分期和肿瘤的异质性,采用手术、化疗、靶向治疗、免疫治疗、介入治疗等“组合拳”进行“打击”,多学科的专家一起,共同提高晚期患者的生存率和生活质量。本文主要从外科医生角度,探讨晚期胃癌诊疗策略的制定。

The incidence of gastric cancer ranks fifth among malignant tumors worldwide,with the fourth highest mortality rate.A noteworthy characteristic of our country is the high prevalence of advanced-stage patients of approximately 40%.Advanced-stage gastric cancer carries an unfavorable prognosis with median survival of around one year.Diagnosis methods for advanced-stage gastric cancer(such as laparoscopic exploration,molecular profiling,and artificial intelligence)are still being continuously improved,while chemotherapy remains the primary treatment.With the rapid development of medical science,the role of surgical intervention in advanced-stage gastric cancer is becoming increasingly prominent.Therefore,as gastric tumor surgeons,we should consider how to use a combination of treatments,including surgery,chemotherapy,targeted therapy,immunotherapy,and interventional therapy,based on different pathological stages and the heterogeneity of tumors.With a multidisciplinary approach involving experts from various fields,we can collectively improve the survival rate and quality of life for advanced-stage patients.This article provides a brief overview of the current advances in the diagnosis and treatment of advanced-stage gastric cancer,and discusses therapeutic decision primarily from the perspective of surgeons.