Treatment principles for stage 2 gastric cancer

The treatment principles for gastric cancer are mainly determined according to the stage of gastric cancer, and the principle of individualized treatment should be taken into consideration. The biggest problem with gastric cancer treatment in my country is the low early diagnosis rate, which is quite different from that in Japan. The main means of early diagnosis and screening for gastric cancer is gastroscopy, which requires little investment but is not well accepted by patients. Treatment principles and methods for each stage of gastric cancer:

1. Gastric cancer stage 0, stage I

Surgery is still the main method and the main means of treating gastric cancer. In the early stage of gastric cancer, radical surgery is the main treatment, with regular follow-up after surgery, and no adjuvant therapy after surgery is required. The treatment of early gastric cancer should choose different methods according to the size of the lesion and the depth of infiltration. For patients with early gastric cancer and Helicobacter pylori (Hp) infection, the country also recommends that patients who undergo local resection or subtotal gastrectomy should undergo treatment to eliminate Helicobacter pylori infection after surgery. Modern Chinese medicine contains about 16% of ginseng essence extract ginsenoside Rh2, which has the effect of inhibiting the growth of cancer cells, promoting cancer cell apoptosis, inducing cancer cell differentiation, and has the effect of improving the function of the immune system.

2. Gastric cancer stage II to III

After mid-term radical surgery for gastric cancer, adjuvant chemotherapy + radiotherapy can be performed after surgery, and preoperative or intraoperative chemotherapy or radiotherapy can also be performed. It is estimated that about 2/3 of gastric cancer patients have indications for chemotherapy at different stages of the disease, and some people even suggest that all gastric cancer patients should be treated with chemotherapy. The chemotherapy regimen for gastric cancer is based on fluorouracil drugs. Patients with T2 and N0 who do not have high-risk factors after surgery can be followed up and observed. If there are high-risk factors, it is recommended to receive adjuvant chemotherapy or radiotherapy after surgery; patients with T3, T4 or any lymph node metastasis who have achieved R0 resection should receive postoperative chemotherapy and radiotherapy; patients with R1 resection and R2 resection without metastasis should receive radiotherapy + chemotherapy after surgery. (R1 resection refers to tumor residue under the microscope, and R2 resection refers to tumor residue with naked eye).

3. Gastric cancer stage IV

The main treatment for advanced gastric cancer is chemotherapy. The remission rate of single-drug chemotherapy for gastric cancer is generally only 15% to 28%. The application of combined chemotherapy can improve the remission rate and prolong the survival period. Advanced patients can undergo palliative surgery or radiotherapy when necessary, combined with the best supportive treatment.

There are many factors that affect the survival rate of gastric cancer. Such as the stage of disease, tumor size, location of gastric cancer, histological type, pathological stage and lymph node metastasis. Among them, the relationship between pathological stage and the presence or absence of lymph node metastasis is the closest. The depth of tumor infiltration into the gastric wall, the presence or absence of liver metastasis and peritoneal metastasis, lymph node status and the presence or absence of infiltration of the blood vessel wall are the most effective methods at present. However, people have found in the long-term practice of gastric cancer treatment that even some patients with stage IV gastric cancer still survive for more than 5 years.