Diagnostic and therapeutic strategies for advanced gastric cancer
10.3760/cma.j.cn431274-20250831-01122
- VernacularTitle:中晚期胃癌诊治策略
- Author:
Zaiyuan YE
1
;
Xiao ZHANG
Author Information
1. 浙江省人民医院（杭州医学院附属人民医院）胃肠胰外科，杭州 310014
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Surgical treatment;
Conversion therapy;
Personalized treatment
- From:
Journal of Chinese Physician
2025;27(10):1441-1450
- CountryChina
- Language:Chinese
-
Abstract:
Gastric cancer is one of the most common digestive system malignancies in China. Most patients are diagnosed at an advanced stage (Stage Ⅲ-Ⅳ), with poor prognosis and great difficulty in treatment. This article systematically summarizes the epidemiological characteristics, diagnostic methods, and comprehensive treatment strategies for advanced gastric cancer. In terms of diagnosis: although serum tumor markers have value in dynamic monitoring, their specificity is limited; molecular markers have gradually become the core basis for precision treatment; imaging, gastroscopy, and laparoscopy form a complementary diagnostic chain, which can improve the accuracy of staging. In terms of treatment: radical surgery remains the main treatment method, emphasizing R0 resection and standardized D2 lymph node dissection; palliative surgery aims to relieve symptoms and improve quality of life. In recent years, the development of conversion therapy has provided surgical opportunities for some initially unresectable patients; local treatments such as proton radiotherapy, hyperthermic intraperitoneal chemotherapy (HIPEC), and radiofrequency ablation also have value in specific populations. The multidisciplinary team (MDT) model and individualized treatment guided by molecular typing have become future development trends. Although problems such as drug resistance and low detection rate of peritoneal metastasis still exist, the application of cytological examination, multi-omics integration, artificial intelligence-assisted diagnosis and treatment, and new targeted and immunotherapies is expected to break through the current bottlenecks in the treatment of advanced gastric cancer and improve patients′ survival and quality of life.
