Content analysis of domestic and international guidelines about comprehensive treatment of advanced gastric cancer

LI Guo-li; XIANG Xiao-song

doi:10.19538/j.cjps.issn1005-2208.2017.10.15

Abstract：In China,advanced gastric cancer with severe local progression or distant metastasis is more common.How to improve the survival of patients with advanced gastric cancer by multimodality therapies,such as splenectomy,bursectomy and neoadjuvant chemotherapy,and the treatment of advanced gastric cancer accompanied by metastasis to the para-aortic lymph nodes or peritoneal metastasis has been focused on by Chinese scholars.Based on the recently released results of JCOG0110 and 1001 research,the fifth edition of Japanese gastric cancer treatment guidelines currently does not recommend conventional combined splenectomy and bursectomy.Compared with the current situation that the advanced gastric cancer is dominant in China,however,these patients of the two projects showed a low degree of progression and malignancy.Therefore,the clinical significance of these two surgeries should not be completely denied in China.There is no unified treatment plan for the local advanced gastric cancer that has no distant metastasis but is difficult to resect.In fact,a large number of studies have demonstrated that neoadjuvant chemotherapy can improve the resection rate of R0 and prolong the survival time.The author finds out that the preoperative chemotherapy with arterial + vein administration can increase the chemotherapy response rate and improve the survival of patients.There are also many domestic and foreign studies have shown that chemotherapy,radiation therapy,intraperitoneal chemotherapy and other multimodality therapies can effectively prolong the survival time of the patients even with advanced gastric cancer accompanied by metastasis to the para-aortic lymph nodes or peritoneal metastasis.The author believes that it is advisable to actively treat patients with advanced gastric cancer in China through the individualized multidisciplinary comprehensive treatment model so as to improve their survival.