Overview
In China, gastric cancer is one of the common tumors of the digestive system, which can occur in all age groups, with atypical symptoms, and is often misdiagnosed as gastritis p gastric ulcer p gastric polyp, etc.
The relationship between lesion characteristics and clinical treatment of gastric cancer
More than half of gastric cancers occur in the gastric sinus and anterior and posterior walls of the stomach, followed by the cardia. Since stomach is a cavernous organ, its anatomical and physiological characteristics are different from those of parenchymal organs such as liver and pancreas, its chances of surgical resection are significantly higher than those of liver cancer and other diseases, but the effect of surgery is greatly related to the early and late diagnosis, pathological pattern and surgical plan. Middle and late stage gastric cancer also has metastasis in liver, abdomen and left supraclavicular lymph nodes, which seriously affects patients’ quality of life.
Treatment methods and current status of gastric cancer
The treatment methods of gastric cancer are constantly updated and progressed. At present, most of them advocate comprehensive treatment based on surgery, especially early gastric cancer. However, the strict selection of surgical indications, the complexity of postoperative complications and the difficulty of controlling adverse reactions after chemotherapy have posed new challenges to the treatment of middle and late stage cases, which occupy the absolute majority in clinical staging.
Characteristics of patients with intermediate and advanced stages and advantages of interventional techniques
Patients with intermediate and advanced stages are often in poor health, have many concomitant lesions and heavy complications, making clinical treatment more difficult. In recent years, the continuous progress and promotion of interventional techniques have provided clinicians with new treatment measures with many advantages such as less invasive, less side effects and wide range of adaptations, which have benefited many patients with intermediate and advanced stages.
Which patients are suitable to choose interventional treatment?
1. Patients with late detection, combined with metastasis to adjacent organs or other sites, who are not suitable for surgical treatment.
2.Patients with poor physical condition and more concomitant lesions (hypertension, diabetes, etc.), who cannot tolerate surgical treatment.
3.Patients who have relapsed after surgery or radiotherapy, or who have more complications and cannot tolerate continued treatment.
4, combined with liver metastasis or abdominal metastasis, large lesions, compression of adjacent organs or important structures (intestinal duct, bile duct, inferior vena cava, etc.), need to reduce the tumor and symptoms as soon as possible, control the growth rate and improve the quality of life.
5.The combination of anastomotic stenosis, anastomotic fistula, obstructive jaundice, intestinal obstruction or inferior vena cava obstruction, which should not be treated by surgery or other methods.
6. Combined with gastrointestinal and anastomotic bleeding, and conservative treatment is ineffective.
7. Patients with advanced stage, who need to provide nutritional support and establish fixed delivery pathway
8. Those who need to implement targeted drugs, biological therapy and other measures in combination with interventional therapy to improve the efficacy.
What are the common methods of interventional treatment for gastric cancer and its metastases and complications?
1.Selective arterial drug infusion
2.Selective arterial embolization
3.Ar-He ultra-low temperature cryopreservation
4.Stenting of bile duct, intestinal duct and inferior vena cava
5.Gastrointestinal fistula
Can interventional therapy be combined with surgery?
The combination of the two can complement each other. Interventional therapy can give some patients with intermediate to advanced disease the opportunity to have surgery and improve the long-term results of surgery.