• 摘要: 胃癌在我国恶性肿瘤中发病率与死亡率均位居前列,其中30%~40%的患者初诊时已处于Ⅳ期,尽管系统性治疗在一定程度上延长了部分患者的生存期,但总体预后仍不理想。近年来,随着精准外科理念的成功实践和肿瘤学研究的快速发展,以免疫治疗、精准分子分型及多组学检测为核心的个体精准化诊疗策略,为Ⅳ期胃癌的治疗提供了新的突破口,如何规范实施Ⅳ期胃癌转化治疗目前国内尚缺乏共识。因此,本共识汇聚国内胃肠外科、肿瘤内科、放射影像学和病理学等多学科专家,系统梳理国内外转化治疗最新循证医学证据,结合中国临床实践痛点,围绕患者分层评估、分子检测指导下的精准治疗、转化成功率预测、手术规划及围术期管理等重点环节进行反复推敲和研讨,制订《精准外科胃癌转化治疗专家共识(2025版)》,旨在规范Ⅳ期胃癌转化治疗的临床实践,为临床医师提供科学、实用的决策参考。

     

    Abstract: Gastric cancer ranks among the most prevalent and lethal malignancies in China, with approximately 30%‒40% of patients diagnosed at stage Ⅳ. Although systemic therapy has modestly improved survival in some cases, the overall prognosis remains poor. In recent years, advancements in precision surgical concepts and oncology research have introduced novel individualized treatment strategies centered on immunotherapy, precision molecular subtyping, and multi-omics testing, offering new opportunities for managing stage Ⅳ gastric cancer. However, there is currently no established consensus in China on the standardized implementation of conversion therapy for stage Ⅳ disease. To address this gap, the Chinese Expert Consensus on Precision Surgery for Gastric Cancer Conversion Therapy (2025 Edition) is developed through multidisciplinary collaboration among experts in gastrointestinal surgery, medical oncology, radiology, and pathology. This consensus systemati-cally reviews the latest clinical evidence on conversion therapy, incorporates insights into critical challenges in Chinese clinical practice, and refines key aspects including patient stratification, molecular-guided precision therapy, prediction of conversion success, surgical planning, and perioperative management. The document aims to standardize clinical practices for stage Ⅳ gastric cancer conversion therapy and provide clinicians with scientifically robust and practical decision-making guidance.

     

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