[Integrated diagnosis and treatment of peritoneal metastasis in gastric cancer].

Journal: Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
Published Date:

Abstract

The high incidence and mortality rates of gastric cancer pose a significant burden on human health and public health systems. Peritoneal metastasis is one of the main routes of metastasis in gastric cancer, and patients with this condition have poor prognosis. With advancements in medicine and sociology, the concept of integrated medicine emerged in the late 1980s. It emphasizes treating patients as holistic entities, integrating various medical fields multidimensionally, and combining medicine with other fields. This article organizes the management of gastric cancer peritoneal metastasis around the core concept of "Prevention, Screening, Diagnosis, Treatment, and Rehabilitation": Prevention relies on standardized tumor-free surgical techniques and intraoperative interventions. Screening involves early detection of peritoneal metastasis through integrated technologies. Diagnosis combines multiple methods, including laparoscopic exploration with cytological and histopathological examination, imaging studies, peritoneal fluid cytology, and artificial intelligence. Treatment encompasses comprehensive strategies such as intraperitoneal and systemic chemotherapy, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy, pressurized intraperitoneal aerosolized chemotherapy, dendritic cell vaccines combined with nivolumab, and supportive care for managing ascites, malignant bowel obstruction, and nutritional support. This integrated medical perspective offers new insights into the management of gastric cancer peritoneal metastasis.

Authors

  • B W Li
    Department of Surgical Oncology and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China Endoscopy Center, the First Hospital of China Medical University, Shenyang 110001, China.
  • P Gao
    Department of Surgical Oncology and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
  • K Feng
    Department of Surgical Oncology and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
  • G T Wu
    Department of Surgical Oncology and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
  • T J Tongjia
    Department of Surgical Oncology and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
  • Z N Wang
    Department of Surgical Oncology and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China.