Abstract:

Recognition and consideration on the evolution trends and directions of the therapeutic strategies for early gastric cancer from the changes of different versions of Japanese Gastric Cancer Treatment Guidelines　　ZHAO En-hao, CAO Hui. Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200217, China
Corresponding author: CAO Hui, E-mail: caohuishcn@hotmail.com
Abstract　With the better diagnosis of early gastric cancer, increasing diversity and complexity of its treatment has united a multidisciplinary team led by physicians and surgeons. Japanese Gastric Cancer Treatment Guidelines are compiled and reviewed by a committee composed of physicians, surgeons and pathologists, which are based on the epidemiological trend of gastric cancer in Japan over the past two decades and clinical evidence from Japanese domestic studies and other prominent international clinical trials. Updated every three to six years, the guidelines now have five versions. They are one of the authoritative documents for the diagnosis and treatment for gastric cancer in the world. As far as the treatment strategies for early gastric cancer are concerned, they include the changes of endoscopic resection, the evolution of minimally invasive surgery, the widespread application of laparoscopic surgery and the promotion of the concept of functional preservation. The evolutionary trends are perfect reflections of a philosophical shift of Japanese physicians towards precision medicine: from radical resection to functional preservation, and from long-term survival only to better quality of life.

Key words: early gastric cancer；minimally invasive surgery；laparoscopy；endoscopic treatment, function persevering gastrectomy；guideline

摘要：

随着早期胃癌的诊断率不断提高，其治疗手段的多样性和复杂性不断增加，包括胃癌治疗已经进入由内外科医师共同参与的多学科团队诊疗的时代。日本《胃癌治疗指南》是在近20年来日本胃癌流行病学变化趋势的背景下，基于日本国内和其他重要国际性临床试验的循证医学依据，由内科、外科和病理科医师共同组成的委员会负责编写和审核，每3～6年更新，至今已有5版，也是目前国际上最为权威的胃癌诊疗规范化、标准化的指导性文件。就早期胃癌而言，包括内镜治疗的变化、缩小手术的演变、腹腔镜手术的广泛应用和保留功能理念的推广，其治疗策略的演变充分体现了日本学者追求从肿瘤根治到微创功能保留，从长期生存的需求到更好生活质量的提高，贯彻了早期胃癌精准治疗的理念和思路。

关键词: 早期胃癌, 微创外科, 腹腔镜, 内镜治疗, 保留功能胃切除术, 指南