Meyer H-J, Wilke H
Städtisches Klinikum Solingen, Klinik für Allgemein- und Viszeralchirurgie, Gotenstrasse 1, Solingen, Germany.
Zentralbl Chir. 2011 Aug;136(4):317-24. doi: 10.1055/s-0031-1271580. Epub 2011 Jul 25.
The overall prognosis of gastric cancer with an overall 5-year survival of 25% is still poor despite improvements of the surgical and perioperative procedures. To improve the surgical treatment results other therapeutic options as chemo- and/or radiotherapy have been investigated for more than 20 years.
After a literature review, the results of actual trials of multimodality treatment were analysed and described.
Adjuvant treatment was less effective compared with neoadjuvant or perioperative chemotherapy performed in advanced tumour categories T3/4. Actual trials could show that the rate of curative (R0) resection can be augmented resulting in an increase of the overall 5-year survival rate of more than 10 %.
To confirm this trend, further studies with high pathological and surgical quality control are necessary as well as a more exact definition of prediction and evaluation of the response following chemotherapy.
尽管外科手术及围手术期治疗方法有所改进,但胃癌的总体预后仍然较差,其5年总生存率仅为25%。为了提高手术治疗效果,人们对化疗和/或放疗等其他治疗选择进行了20多年的研究。
在进行文献综述后,对多模式治疗实际试验的结果进行了分析和描述。
与在晚期肿瘤类别(T3/4)中进行的新辅助或围手术期化疗相比,辅助治疗效果较差。实际试验表明,根治性(R0)切除率可以提高,从而使5年总生存率提高超过10%。
为了证实这一趋势,有必要进行进一步的研究,要有高质量的病理和手术质量控制,以及对化疗反应的预测和评估进行更精确的定义。