Gastric cancer is a significant global contributor to cancer-related mortality. Stage IV gastric cancer represents a significant percentage of patients in Western countries, with peritoneal dissemination being the most prevalent site. Peritoneal disease comprises two distinct entities, macroscopic (P1) and microscopic (P0CY1), which are associated with poor long-term survival rates. Although the present standard of treatment is palliative chemotherapy, a global controversy has arisen concerning specific patients with limited disease burden or conversion to negative lavage cytology following chemotherapy. Available approaches include systemic or intraperitoneal chemotherapy, upfront gastrectomy, and conversion surgery. This review consolidated the current evidence regarding multimodal management, indicating prolonged survival for this distinct subgroup of patients. Considering the complexity of peritoneal metastases, the potential of the multimodal approach unveils promising prospects for identifying the optimal treatment for this particular subset of stage IV patients and thus enhancing their survival outcomes.
胃癌是全球癌症相关死亡率的重要贡献因素。在西方国家，IV期胃癌患者占相当大比例，其中腹膜播散是最常见的转移部位。腹膜疾病包括两种不同实体：肉眼可见转移（P1）和腹腔灌洗细胞学阳性（P0CY1），这两种情况均与长期生存率低下相关。尽管当前标准治疗为姑息性化疗，但对于疾病负荷有限或化疗后腹腔灌洗细胞学转阴的特殊患者群体，全球范围内存在治疗争议。现有治疗策略包括全身化疗或腹腔内化疗、前期胃切除术以及转化手术。本综述整合了当前关于多模式治疗的证据，表明这一特定亚组患者可通过综合治疗获得生存期延长。鉴于腹膜转移的复杂性，多模式治疗策略展现出广阔前景，有望为这类特定IV期患者群体确定最佳治疗方案，从而改善其生存结局。
肿瘤(癌症)患者之家