胃癌腹膜少转移:诊断策略、患者选择和新出现的治疗方法。

IF 3.8 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Hyoung-Il Kim, Brian D Badgwell
{"title":"胃癌腹膜少转移:诊断策略、患者选择和新出现的治疗方法。","authors":"Hyoung-Il Kim, Brian D Badgwell","doi":"10.5230/jgc.2025.25.e36","DOIUrl":null,"url":null,"abstract":"<p><p>Peritoneal metastasis (PM) from gastric cancer is a critical determinant of poor prognosis and has limited therapeutic options. However, recent advances in diagnostic and therapeutic strategies have reshaped the clinical landscape, enabling curative treatment of select patients. Accurate staging based on the peritoneal cancer index (PCI) is central to disease stratification and treatment planning. A PCI threshold of ≤6 has emerged as a consensus-based cutoff to define peritoneal oligometastasis, a limited metastatic state with potential for long-term survival following aggressive multimodal therapy. Therefore, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy remains the cornerstone of curative treatment. Additionally, innovative peritoneum-directed therapies-including normothermic intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy, and pressurized intraperitoneal aerosol chemotherapy- have expanded the therapeutic landscape for both curative and palliative indications. This review highlights the evolving strategies for the diagnosis and treatment of gastric cancer with PM, with emphasis on PCI-based patient selection and treatment optimization. We also discuss the future roles of liquid biopsy, artificial intelligence, and photodynamic therapy in enhancing precision oncology for PM. Defining and targeting peritoneal oligometastases may enable tailored interventions and improve outcomes of this historically intractable disease.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"25 3","pages":"409-423"},"PeriodicalIF":3.8000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260789/pdf/","citationCount":"0","resultStr":"{\"title\":\"Peritoneal Oligometastasis in Gastric Cancer: Diagnostic Strategies, Patient Selection, and Emerging Therapeutic Approaches.\",\"authors\":\"Hyoung-Il Kim, Brian D Badgwell\",\"doi\":\"10.5230/jgc.2025.25.e36\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Peritoneal metastasis (PM) from gastric cancer is a critical determinant of poor prognosis and has limited therapeutic options. However, recent advances in diagnostic and therapeutic strategies have reshaped the clinical landscape, enabling curative treatment of select patients. Accurate staging based on the peritoneal cancer index (PCI) is central to disease stratification and treatment planning. A PCI threshold of ≤6 has emerged as a consensus-based cutoff to define peritoneal oligometastasis, a limited metastatic state with potential for long-term survival following aggressive multimodal therapy. Therefore, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy remains the cornerstone of curative treatment. Additionally, innovative peritoneum-directed therapies-including normothermic intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy, and pressurized intraperitoneal aerosol chemotherapy- have expanded the therapeutic landscape for both curative and palliative indications. This review highlights the evolving strategies for the diagnosis and treatment of gastric cancer with PM, with emphasis on PCI-based patient selection and treatment optimization. We also discuss the future roles of liquid biopsy, artificial intelligence, and photodynamic therapy in enhancing precision oncology for PM. Defining and targeting peritoneal oligometastases may enable tailored interventions and improve outcomes of this historically intractable disease.</p>\",\"PeriodicalId\":56072,\"journal\":{\"name\":\"Journal of Gastric Cancer\",\"volume\":\"25 3\",\"pages\":\"409-423\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260789/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Gastric Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5230/jgc.2025.25.e36\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastric Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5230/jgc.2025.25.e36","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

胃癌腹膜转移(PM)是不良预后的关键决定因素,治疗选择有限。然而,诊断和治疗策略的最新进展已经重塑了临床景观,使选定的患者能够治愈治疗。基于腹膜癌指数(PCI)的准确分期是疾病分层和治疗计划的核心。PCI阈值≤6已成为定义腹膜少转移的共识,这是一种有限的转移状态,在积极的多模式治疗后具有长期生存的潜力。因此,细胞减少手术联合腹腔内高温化疗仍然是根治性治疗的基石。此外,创新的腹膜定向治疗——包括常温腹腔化疗、术后早期腹腔化疗和加压腹腔气溶胶化疗——扩大了治疗和姑息适应症的治疗前景。本文综述了胃癌PM的诊断和治疗策略的发展,重点是基于pci的患者选择和治疗优化。我们还讨论了液体活检、人工智能和光动力治疗在提高PM精确肿瘤学方面的未来作用。定义和靶向腹膜寡转移瘤可能使有针对性的干预和改善这种历史上难治性疾病的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Peritoneal Oligometastasis in Gastric Cancer: Diagnostic Strategies, Patient Selection, and Emerging Therapeutic Approaches.

Peritoneal Oligometastasis in Gastric Cancer: Diagnostic Strategies, Patient Selection, and Emerging Therapeutic Approaches.

Peritoneal Oligometastasis in Gastric Cancer: Diagnostic Strategies, Patient Selection, and Emerging Therapeutic Approaches.

Peritoneal Oligometastasis in Gastric Cancer: Diagnostic Strategies, Patient Selection, and Emerging Therapeutic Approaches.

Peritoneal metastasis (PM) from gastric cancer is a critical determinant of poor prognosis and has limited therapeutic options. However, recent advances in diagnostic and therapeutic strategies have reshaped the clinical landscape, enabling curative treatment of select patients. Accurate staging based on the peritoneal cancer index (PCI) is central to disease stratification and treatment planning. A PCI threshold of ≤6 has emerged as a consensus-based cutoff to define peritoneal oligometastasis, a limited metastatic state with potential for long-term survival following aggressive multimodal therapy. Therefore, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy remains the cornerstone of curative treatment. Additionally, innovative peritoneum-directed therapies-including normothermic intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy, and pressurized intraperitoneal aerosol chemotherapy- have expanded the therapeutic landscape for both curative and palliative indications. This review highlights the evolving strategies for the diagnosis and treatment of gastric cancer with PM, with emphasis on PCI-based patient selection and treatment optimization. We also discuss the future roles of liquid biopsy, artificial intelligence, and photodynamic therapy in enhancing precision oncology for PM. Defining and targeting peritoneal oligometastases may enable tailored interventions and improve outcomes of this historically intractable disease.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信