Abstract:

Reports from the 90th Annual Meeting of the Japanese Gastric Cancer Association        LIANG Han. Department of Gastrointestinal Oncological Surgery, Tianjin Cancer Hospital, Tianjin Medical University, National Clinical Research Center for Cancer, Key Laborary of Cancer Prevention and Therapy, Tianjin 300060, China
Abstract    According to the 15th Japanese Classification of Gastric Carcinoma，No.6 lymph nodes are redefined as No.6a，No.6v and No.6i. Revision of macroscopic peritoneal metastasis （P1） has been made according to the metastasis extent，P1 is divided into P1a，P1b and P1c. In case with duodenal invasion of gastric cancer，if No.13 lymph nodes metastasis is present，such metastasis is considered to be regional but not M1. No.14v re-defined as regional node，but it is not recommended including to the D2 dissection. EGJ was re-defined and the definition of EGJ cancer is depended on the endoscopic findings，upper gastrointestinal series and pathological study. In the Japanese gastric cancer treatment guidelines，the 5th edition，26 clinical questions were collected the final recommendations were made by the Guideline Committee. Palliative gastrectomy plus chemotherapy is not recommended as a treatment for advanced gastric cancer. Splenectomy is not recommended to the standard D2 procedure for proximal gastric cancer that does not invade the greater curvature. Bursectormy is not recommended as a standard treatment for cT3/4 gastric cancer. The indication for laparoscopy-assisted gastrectomy is extended. Neu-adjuvant chemotherapy plus extended lymphadenectomy or co-resection are recommended for the selected patients.

Key words: Japanese Gastric Cancer Association, gastric carcinoma, guidelines, classification

摘要：

第15版日本《胃癌处理规约》对胃癌分期修订了幽门下组淋巴结，将其分成No.6a、No.6v和No.6i 3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。将No.14v重新归为区域淋巴结，但是未包含在D2清扫范围。重新界定了食管胃结合部癌的定义。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学诊断。明确了Siewert Ⅲ型食管胃结合部癌遵循胃癌TNM分期。第5版日本《胃癌治疗指南》继续采取Minds模式一共归纳了26个临床问题，最终经过指南委员会的充分讨论并给出推荐意见。不推荐姑息手术+化疗的治疗模式，不推荐对近端非大弯侧胃癌进行脾切除，对于cT3/4期胃癌不推荐网膜囊切除。扩大了腹腔镜的手术适应证。对于选择性病例，可以采取新辅助化疗+扩大根治手术，或联合切除模式。

关键词: 日本胃癌学会, 胃癌, 指南, 分期