精准外科胃癌转化治疗专家共识(2025版)  

Expert consensus on precision surgery for gastric cancer conversion therapy(2025 edition)

作　　者：中华医学会外科学分会腹腔镜与内镜外科学组 中国抗癌协会胃癌专业委员会 中国抗癌协会腔镜与机器人外科分会 《中华消化外科杂志》编辑委员会 郑民华[2] 季加孚[3] 陈凛 臧潞[5] 曹晖[6] 李国新[7] 余佩武 陈敏 马君俊[10] 赵轩[10] Laparoscopic&Endoscopic Surgery Group,Branch of Surgery,Chinese Medical Association;Gastric Cancer Professional Committee,China Anti-Cancer Association;Endoscopic and Robotic Surgical Society,China Anti-Cancer Association;Editorial Board of the Chinese Journal of Digestive Surgery;Zheng Minghua;Ji Jiafu;Chen Lin;Zang Lu(不详;Department of General Surgery,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai Minimal Invasive Surgery Center,Shanghai 200025,China;Department of Gastrointestinal Surgery,Peking University Cancer Hospital&Institute,Beijing Institute for Cancer Research,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Beijing 100142,China;Department of Gastrointestinal Surgery,Peking University International Hospital,Beijing 102206;Department of Gastrointestinal Surgery,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China)

机构地区：[1]不详 [2]上海交通大学医学院附属瑞金医院普通外科、上海市微创外科临床医学中心,上海200025 [3]北京大学肿瘤医院暨北京市肿瘤防治研究所胃肠肿瘤中心、教育部恶性肿瘤发病机制及转化研究重点实验室,北京100142 [4]北京大学国际医院胃肠外科,北京102206 [5]上海交通大学医学院附属瑞金医院胃肠外科,上海200025 [6]上海交通大学医学院附属仁济医院 [7]清华大学附属北京清华长庚医院 [8]陆军军医大学第一附属医院 [9]《中华消化外科杂志》编辑委员会 [10]上海交通大学医学院附属瑞金医院

出　　处：《中华消化外科杂志》2025年第3期281-292,共12页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(82372933,8241540220,82072614);中国科技期刊卓越行动计划(卓越二期-B1-090)。

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。Gastric cancer ranks among the most prevalent and lethal malignancies in China,with approximately 30%‒40%of patients diagnosed at stageⅣ.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 stageⅣgastric cancer.However,there is currently no established consensus in China on the standardized implementation of conversion therapy for stageⅣdisease.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 systematically reviews the latest clinical evidence on conversion therapy,incorporates insights into critical challenges in Chinese clinical practice,and refines key aspects including patient stratification,molecularguided 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.

关 键 词：胃肿瘤 外科治疗 精准 转化治疗 专家共识 

分 类 号：R735.2[医药卫生—肿瘤]