Gastric cancer(GC)is one of the most common malignancies worldwide and surgery remains the only potentially curative treatment option for it.Although a significant proportion of GC patients are found with distant meta...Gastric cancer(GC)is one of the most common malignancies worldwide and surgery remains the only potentially curative treatment option for it.Although a significant proportion of GC patients are found with distant metastases already at the initial diagnosis.Peritoneal dissemination is the most common site of metastases.Positive peritoneal cytology(Cy1)is associated with poor long-term outcomes;thus,these patients are considered as stage IV even if macroscopic carcinomatosis is absent.Currently,there is no clear evidence for the most optimal treatment for this distinct subpopulation of the stage IV cohort.Available strategies vary from palliative chemotherapy to upfront gastrectomy.This comprehensive review summarized current evidence of different treatment strategies for Cy1 GC including roles of surgery,systemic and intraperitoneal chemotherapy.展开更多
Gastric cancer is one of the most common malignancies worldwide and gastrectomy remains the only potentially curative treatment option for this disease.However,the surgery leads to significant physiological and anatom...Gastric cancer is one of the most common malignancies worldwide and gastrectomy remains the only potentially curative treatment option for this disease.However,the surgery leads to significant physiological and anatomical changes in the gastrointestinal(GI)tract including loss of the gastric barrier,an increase in oxygenation levels in the distal gut,and biliary diversion after gastrectomy.These changes in the GI tract influence the composition of the gut microbiome and thus,host health.Gastrectomy-induced dysbiosis is characterized by increased abundance of typical oral cavity bacteria,an increase in aero-tolerant bacteria(aerobes/facultative anaerobes),and increased abundance of bile acidtransforming bacteria.Furthermore,this dysbiosis is linked to intestinal inflammation,small intestinal bacterial overgrowth,various GI symptoms,and an increased risk of colorectal cancer.展开更多
文摘Gastric cancer(GC)is one of the most common malignancies worldwide and surgery remains the only potentially curative treatment option for it.Although a significant proportion of GC patients are found with distant metastases already at the initial diagnosis.Peritoneal dissemination is the most common site of metastases.Positive peritoneal cytology(Cy1)is associated with poor long-term outcomes;thus,these patients are considered as stage IV even if macroscopic carcinomatosis is absent.Currently,there is no clear evidence for the most optimal treatment for this distinct subpopulation of the stage IV cohort.Available strategies vary from palliative chemotherapy to upfront gastrectomy.This comprehensive review summarized current evidence of different treatment strategies for Cy1 GC including roles of surgery,systemic and intraperitoneal chemotherapy.
文摘Gastric cancer is one of the most common malignancies worldwide and gastrectomy remains the only potentially curative treatment option for this disease.However,the surgery leads to significant physiological and anatomical changes in the gastrointestinal(GI)tract including loss of the gastric barrier,an increase in oxygenation levels in the distal gut,and biliary diversion after gastrectomy.These changes in the GI tract influence the composition of the gut microbiome and thus,host health.Gastrectomy-induced dysbiosis is characterized by increased abundance of typical oral cavity bacteria,an increase in aero-tolerant bacteria(aerobes/facultative anaerobes),and increased abundance of bile acidtransforming bacteria.Furthermore,this dysbiosis is linked to intestinal inflammation,small intestinal bacterial overgrowth,various GI symptoms,and an increased risk of colorectal cancer.
