Gastric adenocarcinoma

被引:437
作者
Ajani, Jaffer A. [1 ]
Lee, Jeeyun [2 ]
Sano, Takeshi [3 ]
Janjigian, Yelena Y. [4 ]
Fan, Daiming [5 ]
Song, Shumei [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Gastrointestinal Med Oncol, 1515 Holcombe Blvd, Houston, TX 77030 USA
[2] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Div Hematol Oncol,Dept Med, Seoul, South Korea
[3] Canc Inst Hosp, Dept Gastroenterol Surg, Tokyo, Japan
[4] Mem Sloan Kettering Canc Ctr, Dept Solid Tumor Gastrointestinal Serv Med Oncol, 1275 York Ave, New York, NY 10021 USA
[5] Fourth Mil Med Univ, Xijing Hosp Digest Dis, State Key Lab Canc Biol, Xian, Peoples R China
关键词
QUALITY-OF-LIFE; PHASE-III TRIAL; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; GASTROESOPHAGEAL JUNCTION CANCER; CAPECITABINE PLUS OXALIPLATIN; ISLAND METHYLATOR PHENOTYPE; DEPENDENT KINASE INHIBITOR; ADVERSE PROGNOSTIC-FACTOR; LYMPH-NODE DISSECTION; HELICOBACTER-PYLORI;
D O I
10.1038/nrdp.2017.36
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Gastric cancers, with gastric adenocarcinoma (GAC) as the most common histological type, impose a considerable global health burden. Although the screening strategies for early detection have been shown to be successful in Japan and South Korea, they are either not implemented or not feasible in most of the world, leading to late diagnosis in most patients. Helicobacter pylori infection contributes to the development of many endemic GACs, and pre-emptive eradication or early treatment of this bacterial infection might provide effective primary prevention. GACs are phenotypically and genotypically heterogeneous. Localized (clinical stage I) GAC is best treated either endoscopically or with limited surgical resection, but clinical stage II or stage III tumours require multidisciplinary adjunctive approaches in addition to surgery. Although GAC is highly treatable in its early stages, advanced (clinical stage IV) GAC has a median survival of just similar to 9-10 months. However, detailed molecular and immune profiling of GAC is yielding promise; early studies with immune checkpoint inhibitors suggest that GAC is amenable to immune modulation. Molecular studies have yielded a vast quantity of new information for potential exploitation. Nevertheless, advances against GACs have lagged compared with other tumours of similar incidence, and more research is necessary to overcome the obstacles to prolong survival.
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页数:19
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