“第89届日本胃癌学会年会”特别演讲重要内容介绍

发布时间：2018-03-13 03:22

  本文选题：日本胃癌学会　切入点：胃癌　出处：《中国实用外科杂志》2017年04期 　论文类型：期刊论文

【摘要】：第5版日本《胃癌治疗指南》缩小了胃癌标准手术的切除范围,不推荐对近端非大弯侧胃癌行脾切除,对于c T3/4期胃癌不推荐行网膜囊切除。对于IV期病例,不推荐手术+化疗的治疗模式,化疗+手术可能是选项之一。扩大了早期胃癌行内镜黏膜下剥离术(ESD)的绝对适应证。增加了新的化疗药物、靶向药物和化疗方案,例如奥沙利铂和RAM单抗被批准用于胃癌的化疗和靶向治疗。扩大了卡培他滨和奥沙利铂用于围手术期化疗的适应证。选择了30~40个临床问题,经过讨论后给予最可能的回答。第15版日本《胃癌处理规约》与第8版国际抗癌联盟/美国癌症联合委员会(UICC/AJCC)胃癌分期系统进行了整合,该分期是基于国际胃癌学会胃癌TNM分期项目的结果修订的,第一次体现了国际化。第15版日本《胃癌处理规约》修订了幽门下组淋巴结,将其分成No.6a、No.6v和No.6i三个亚组。对腹膜转移分级进行修订,将P1按转移范围进一步分成P1a、P1b和P1c。如果胃窦癌侵犯十二指肠,No.13淋巴结发生转移,应该视为区域淋巴结转移,不做为M1对待。传统意义的R0不适用于对ESD手术质量的评估。食管胃结合部癌的诊断标准应该结合内镜所见、上消化道造影及病理诊断。对化疗疗效评价标准进行修订,确定了肿瘤消退的界值为10%。
[Abstract]:The fifth edition of Japan's guidelines for the treatment of gastric Cancer narrowed the scope of the standard surgical procedures for gastric cancer. Splenectomy for proximal non-large curved gastric cancer was not recommended. Omentum sac resection was not recommended for stage c T 3 / 4 gastric cancer. Surgery is not recommended for chemotherapy. Chemotherapy may be one of the options. It expands the absolute indication of endoscopic submucosal dissection of early gastric cancer. New chemotherapeutic drugs, targeted drugs, and chemotherapy protocols are added. For example, oxaliplatin and RAM monoclonal antibodies were approved for chemotherapy and targeted therapy for gastric cancer. The indications for capecitabine and oxaliplatin for perioperative chemotherapy were expanded. 30 to 40 clinical problems were selected. After discussion, the most likely answer was given. The 15th edition of Japan's gastric Cancer treatment Protocol was integrated with the 8th edition of the UICC / AJCC-UICC / AJCC gastric cancer staging system. The staging is based on the results of the International gastric Cancer Society's TNM staging project, which is the first to reflect internationalization. The 15th edition of Japan's gastric Cancer treatment Protocol revised the subpyloric lymph nodes. It was divided into three subgroups, No. 6aAU No. 6v and No.6i. The peritoneal metastasis classification was revised to further divide P1 into P1aAU P1b and P1c.If gastric antral carcinoma invades duodenal No. 13 lymph node metastasis, it should be regarded as regional lymph node metastasis. Not treated as M1. Traditional R0 is not suitable for evaluating the quality of ESD surgery. The diagnostic criteria for esophageal and gastric carcinoma should be combined with endoscopic findings, upper gastrointestinal angiography and pathological diagnosis. The criteria for evaluating the efficacy of chemotherapy should be revised. The cutoff value of tumor regression was determined to be 10.
【作者单位】： 天津医科大学肿瘤医院胃部肿瘤科国家肿瘤临床医学研究中心天津市肿瘤防治重点实验室;
【分类号】：R735.2
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