Table CDR62911 Gastric Cancer Treatment/胃癌治疗
ID Type Description_en Description_zh
w1 Word Intestinal 肠型
w2 Word Diffuse 弥漫型
w3 Word Deaths: 10,990 死亡病例数：10,990例
w4 Word Male gender 男性
w5 Word Intestinal metaplasia 肠上皮化生
w6 Word Stage explanation--legacy 分期--legacy
w7 Word Perioperative chemotherapy 围手术期化疗
w8 Word Postoperative chemotherapy 术后化疗
w9 Word Radical surgery 胃癌根治术
w10 Word Advanced age 老年
w11 Word Pernicious anemia 恶性贫血
p1 Phrase Treatment by stage--legacy 依据分期的治疗--legacy
p2 Phrase Gastric adenomatous polyps 胃腺瘤性息肉
p3 Phrase New cases: 21,600 新发病例数：21,600例
p4 Phrase Definitions of TNM TNM分期定义
p5 Phrase Familial adenomatous polyposis 家族性腺瘤性息肉病
p6 Phrase Chronic atrophic gastritis 慢性萎缩性胃炎
p7 Phrase Helicobacter pylori gastric infection 胃幽门螺旋杆菌感染
p8 Phrase Stage II Gastric Cancer II期胃癌
p9 Phrase Further follow-up is anticipated 尚需进一步随访
p10 Phrase Stage III Gastric Cancer III期胃癌
p11 Phrase stage I gastric cancer I期胃癌
p12 Phrase Stage I Gastric Cancer I期胃癌
p13 Phrase Table 3. Distant Metastasis 表3. 远处转移
p14 Phrase Gastrointestinal Stromal Tumors Treatment 胃肠道间质肿瘤治疗
p15 Phrase stage 0 gastric cancer 0期胃癌
p16 Phrase Stage 0 Gastric Cancer 0期胃癌
p17 Phrase Tumor invades adjacent structures 肿瘤侵犯邻近结构
p18 Phrase Tumor invades muscularis propria 肿瘤侵犯固有肌层
p19 Phrase stage III gastric cancer III期胃癌
p20 Phrase stage IV gastric cancer IV期胃癌
p21 Phrase stage II gastric cancer II期胃癌
p22 Phrase Gastric Cancer (PDQ®): Treatment 胃癌（PDQ®）：治疗
p23 Phrase Tumor invades serosa (visceral peritoneum) 肿瘤侵犯浆膜（脏层腹膜）
p24 Phrase Table 4. Anatomic Stage/Prognostic Groups 表4. 解剖分期/预后分组
p25 Phrase General Information About Gastric Cancer 胃癌基本信息
p26 Phrase Stage Information for Gastric Cancer 胃癌分期信息
p27 Phrase Table 1. Primary Tumor (T) 表1. 原发肿瘤（T）
p28 Phrase Menetrier disease (giant hypertrophic gastritis) 梅内特里耶病（肥厚性胃炎）
p29 Phrase Cellular Classification of Gastric Cancer 胃癌的细胞学分类
p30 Phrase Family history of gastric cancer 胃癌家族史
p31 Phrase No evidence of primary tumor 无原发肿瘤的证据
p32 Phrase No regional lymph node metastasis 无区域淋巴结转移
p33 Phrase Regional lymph node(s) cannot be assessed 区域淋巴结无法评估
p34 Phrase Diet low in fruits and vegetables 新鲜果蔬摄入减少
p35 Phrase Metastases in ≥16 regional lymph nodes ≥16个区域淋巴结转移
p36 Phrase Stage IV and Recurrent Gastric Cancer IV期胃癌与复发胃癌
p37 Phrase Metastases in 7–15 regional lymph nodes 7-15个区域淋巴结转移
p38 Phrase Table 2. Regional Lymph Nodes (N) 表2.区域淋巴结（N）
p39 Phrase Ongoing studies are evaluating these newer regimens 多项研究正在评估这些新化疗方案的有效性
p40 Phrase Patients were randomized in a 1:1 fashion 以1：1比例对患者随机分组
p41 Phrase Tumor invades lamina propria or muscularis mucosae 肿瘤侵犯粘膜固有层或粘膜肌层
p42 Phrase An American series has confirmed these results 另一项美国的系列临床研究亦证实了这一结果
p43 Phrase Time-to-treatment progression (TTP) was the primary endpoint 选择疾病进展时间（TTP）为主要终点
s1 Sentence The lead reviewers for Gastric Cancer Treatment are: 胃癌治疗的首席审核人为：
s2 Sentence There were high toxicity rates in both arms 两组均观察到高毒性反应发生率
s3 Sentence In this case, the tumor is classified T3 这种情况下，肿瘤分期为T3
s4 Sentence Tumor grade may also provide some prognostic information 肿瘤分级也可提供部分预后信息
s5 Sentence Tumor invades lamina propria, muscularis mucosae, or submucosa 肿瘤侵犯粘膜固有层、粘膜肌层或粘膜下层
s6 Sentence Diet high in salted, smoked, or preserved foods 高盐饮食、熏制、防腐食物的高摄入
s7 Sentence Stage 0 is gastric cancer confined to mucosa 0期胃癌指局限于粘膜层的胃癌
s8 Sentence Tumor invades serosa (visceral peritoneum) or adjacent structures 肿瘤侵犯浆膜（脏层腹膜）或邻近结构
s9 Sentence Gastrointestinal stromal tumors occur most commonly in the stomach 胃肠道间质肿瘤最常见于胃
s10 Sentence Crossover to trastuzumab at disease progression was not permitted 疾病进展后患者不可改用曲妥珠单抗
s11 Sentence Unusual Cancers of Childhood (childhood cancer of the stomach) 儿童罕见癌症（儿童型胃癌）
s12 Sentence Palliative radiation therapy may alleviate bleeding, pain, and obstruction 姑息放疗可能有助于缓解出血、疼痛与梗阻
s13 Sentence Expert-reviewed information summary about the treatment of gastric cancer 胃癌治疗的专家审核信息
s14 Sentence The reasons for these temporal changes in incidence are unclear 但这种发病率随时间变化的原因尚不明确
s15 Sentence These tumors often involve the submucosal lymphatics of the esophagus 此类肿瘤常累及食管粘膜下淋巴组织
s16 Sentence If the lesion diffusely involves the stomach, total gastrectomy is required 若病变弥漫全胃，需行全胃切除术
s17 Sentence Some tumors can have mixed features of intestinal and diffuse types 一些肿瘤兼具有肠型与弥漫型的混合特征
s18 Sentence All patients with tumors that can be resected should undergo surgery 肿瘤可切除者应行手术
s19 Sentence There are two major types of gastric adenocarcinoma including the following: 胃腺癌主要分为两类：
s20 Sentence Other PDQ summaries containing information related to gastric cancer include the following: 含有胃癌相关信息的其他PDQ总结包括：
s21 Sentence Proximal subtotal gastrectomy or total gastrectomy (if the lesion involves the cardia) 近端胃大部切除术或全胃切除术（若病变累及贲门）
s22 Sentence Carcinoma in situ : intraepithelial tumor without invasion of the lamina propria 原位癌：上皮内肿瘤，未侵犯粘膜固有层
s23 Sentence Palliative resection should be reserved for patients with continued bleeding or obstruction 持续出血或梗阻的患者应争取行姑息性切除术
s24 Sentence There are conflicting data regarding relative efficacy of any one regimen for another 关于方案相对有效性优劣，目前证据存在争议
s25 Sentence Postoperative chemoradiation therapy may be considered for patients with stage II gastric cancer II期胃癌患者术后应考虑放化疗
s26 Sentence Tumor penetrates subserosal connective tissue without invasion of visceral peritoneum or adjacent structures 肿瘤穿透浆膜下结缔组织，未侵犯脏层腹膜或周围结构
s27 Sentence (Refer to the PDQ summary on Gastrointestinal Stromal Tumors Treatment for more information.) （更多信息参见PDQ总结胃肠道间质肿瘤治疗）
s28 Sentence Chemotherapy consisted of cisplatin plus 5-FU or capecitabine chosen at the investigator’s discretion 化疗药物包括顺铂联合5-FU亦或卡培他滨，由研究者选择
s29 Sentence Diffuse adenocarcinomas are undifferentiated or poorly differentiated, and they lack a gland formation 弥漫型胃腺癌多为低分化或未分化癌，缺乏腺体样排列
s30 Sentence In localized distal gastric cancer, more than 50% of patients can be cured 超过50%的局限性远端胃癌可被治愈
s31 Sentence Postoperative chemoradiation therapy may be considered for patients with stage III gastric cancer III期胃癌患者可考虑术后放化疗
s32 Sentence Investigators in Europe evaluated the role of preoperative and postoperative chemotherapy without radiation therapy 一些欧洲学者评估了单独使用术前和术后化疗而不进行放疗的效果
s33 Sentence Postoperative chemoradiation with ECF such as in the CALGB-80101 trial, which is now closed 已结束的CALGB-80101临床研究推荐术后放疗联合ECF方案化疗
s34 Sentence Estimated new cases and deaths from gastric cancer in the United States in 2013: 据估计，2013年美国胃癌新发病例与死亡病例数分别为：
s35 Sentence Postoperative chemoradiation therapy for patients with node-positive (T1 N1) and muscle-invasive (T2 N0) disease 淋巴结转移（T1 N1）和肌层浸润（T2 N0）的患者术后应进行辅助放化疗
s36 Sentence While the precise etiology is unknown, acknowledged risk factors for gastric cancer include the following: 尽管具体病因不详，但目前已知的危险因素如下：
s37 Sentence Clinically, diffuse adenocarcinomas can give rise to infiltration of the gastric wall (i.e., linitis plastica) 临床上弥漫型胃腺癌可浸润整个胃壁（又称皮革胃）
s38 Sentence Postoperative chemoradiation therapy with ECF as evidenced in the CALGB-80101 trial, which is now closed 已结束的CALGB-80101临床研究推荐术后进行放疗联合ECF方案化疗的治疗
s39 Sentence Note that in patients with stage I gastric cancer, perigastric lymph nodes may contain cancer 特别注意I期胃癌患者可能有胃周围淋巴结转移
s40 Sentence Of the 202 patients enrolled, 133 received salvage chemotherapy and 69 received best supportive care 在参与研究的202例患者中，133例患者接受补救性化疗，69例患者接受最佳支持治疗
s41 Sentence When patients develop progression of disease after first-line chemotherapy, there is no standard treatment option 对于一线化疗后疾病进展的患者，尚无标准的治疗选择
s42 Sentence At a minimum, surgical resection should include greater and lesser curvature perigastric regional lymph nodes 并应至少清扫胃大弯和胃小弯的胃周围淋巴结
s43 Sentence However, only 36 patients in the trial had stage IB tumors (18 patients in each arm) 然而该研究中临床分期为IB的患者仅有36例（每组18例）
s44 Sentence Subsequently, investigators in Asia evaluated the role of capecitabine/oxaliplatin as adjuvant therapy after gastric cancer resection 此后一些亚洲学者研究了卡培他滨、奥沙利铂作为胃癌切除术后辅助化疗药物的疗效
s45 Sentence Endoluminal laser therapy, endoluminal stent placement, or gastrojejunostomy, may be helpful to patients with gastric obstruction 对于有梗阻的患者，可腔内支架植入、腔内激光治疗，或胃空肠吻合术缓解症状
s46 Sentence All newly diagnosed patients with stage II gastric cancer should be considered candidates for clinical trials 所有新诊断的II期胃癌患者均可作为临床研究备选受试者
s47 Sentence As such, adjuvant external-beam radiation therapy with combined chemotherapy has been evaluated in the United States 因此目前美国已经开始评估辅助体外放疗联合化疗的治疗方案
s48 Sentence All newly diagnosed patients with stage III gastric cancer should be considered candidates for clinical trials 所有新诊断的III期胃癌患者均应作为临床研究备选受试者
s49 Sentence The 3-year OS rate was 80.1% in the S-1 group and 70.1% in the surgery-only group S-1组的3年总生存率为80.1%，单纯手术组则为70.1%
s50 Sentence The American Joint Committee on Cancer has designated staging by TNM classification to define gastric cancer 美国癌症联合委员会（AJCC）对胃癌进行了TMN分期定义：
s51 Sentence Proximal subtotal gastrectomy or total gastrectomy, both with distal esophagectomy (if the lesion involves the cardia) 近端胃大部切除术或全胃切除术，合并远端食管切除术（若病变累及贲门）
s52 Sentence Surgical resection with regional lymphadenectomy is the treatment of choice for patients with stage II gastric cancer 胃切除术联合区域淋巴结清扫术是II期胃癌患者的标准治疗
s53 Sentence If the lesion diffusely involves the stomach, total gastrectomy and appropriate lymph node resection may be required 若病变弥漫全胃，需行全胃切除术联合相应的淋巴结清扫
s54 Sentence Surgical resection including regional lymphadenectomy is the treatment of choice for patients with stage I gastric cancer 胃切除术联合区域淋巴结清扫是I期胃癌患者的首选治疗
s55 Sentence Since that time, incidence has remained steady, with an incidence of 1.94 cases per 100,000 individuals (2003–2008) 此后发病率基本稳定在1.94/100,000人（2003-2008年）
s56 Sentence Palliative chemotherapy with: Irinotecan and cisplatin Folic acid, 5-FU, and irinotecan (FOLFIRI) Leucovorin, 5-FU, and oxaliplatin (FOLFOX) 下列药物应用于姑息性化疗伊立替康与顺铂叶酸，5-FU联合伊立替康（FOLFIRI）亚叶酸钙，5-FU联合奥沙利铂（FOLFOX）
s57 Sentence In patients with node-positive (T1 N1) and muscle-invasive (T2 N0) disease, postoperative chemoradiation therapy may be considered 对于存在淋巴结转移（T1N1）或肌层浸润（T2N0）的胃癌，术后应考虑进行放化疗
s58 Sentence In the United States, gastric cancer ranks 14th in incidence among the major types of cancer malignancies 在美国人群常见的恶性肿瘤中，胃癌发病率位列14
s59 Sentence Intestinal adenocarcinomas are well differentiated, and the cells tend to arrange themselves in tubular or glandular structures 肠型腺癌分化较好，肿瘤细胞多呈管状结构分布
s60 Sentence Of all the combination regimens, ECF is often considered the reference standard in the United States and Europe 所有联合化疗方案中，ECF方案常被美国和欧洲国家作为参考标准
s61 Sentence When the lesion involves the cardia, proximal subtotal gastrectomy or total gastrectomy may be performed with curative intent 病变累及贲门时，为达到根治性目的，可进行近端胃大部切除术或全胃切除术
s62 Sentence Additional studies are needed to confirm the observed increases in noncardia gastric cancers in this specific age group 在这一年龄组别人群中的非贲门胃癌发病率的升高仍需进一步研究证实
s63 Sentence The rate of distant metastases was 32% for the surgery-alone arm and 40% for the chemoradiation therapy arm 单纯手术组的远处转移率为32%，放化疗组为40%
s64 Sentence There was no difference in median OS between docetaxel and irinotecan (5.2 months vs. 6.5 months, P = .116) 使用多西他赛与伊立替康的患者中位总生存时间无显著差异（分别为5.2与6.5个月，P=.116）
s65 Sentence With 5 years' median follow-up, a significant survival benefit was reported for patients who received adjuvant combined modality therapy 在中位数为5年的随访中，接受术后联合治疗的患者生存率显著较高
s66 Sentence The role of extended lymph node (D2) dissection is uncertain and in some series is associated with increased morbidity D2淋巴结清扫的作用尚不明确，系列研究报道称其与并发症增加相关
s67 Sentence Management of adenocarcinoma histology, which accounts for 90% to 95% of all gastric malignancies, is discussed in this summary 胃癌的主治学类型主要为腺癌，占所有胃部恶性肿瘤的90%-95%，本章重点讨论此类胃癌
s68 Sentence In one European trial, 274 patients with metastatic esophagogastric cancer were randomly assigned to receive either ECF or FAMTX 欧洲一项临床研究将274例转移性食管-胃癌患者随机分组接受ECF或FAMTX化疗
s69 Sentence Neoadjuvant chemoradiation therapy such as in the SWOG-S0425, which is now closed, and the RTOG-9904 trial, which is now completed 新辅助放化疗，如已结束的SWOG-S0425与已完成的RTOG-9904临床试验
s70 Sentence Curative resection procedures are confined to patients who do not have extensive nodal involvement at the time of surgical exploration 手术探查中未发现有广泛淋巴结转移者可接受此根治性治疗
s71 Sentence Even with apparent localized disease, the 5-year survival rate of patients with proximal gastric cancer is only 10% to 15% 对于近端胃癌患者，即使是很明确的局限性病变，其5年生存率也只有10%-15%
s72 Sentence The terms tubular, papillary, and mucinous are assigned to the various types of intestinal adenocarcinomas. Rarely, adenosquamous cancers can occur 肠型腺癌又分管状、乳头状和粘液性腺癌，腺鳞癌罕见
s73 Sentence If there is perforation of the visceral peritoneum covering the gastric ligaments or the omentum, the tumor should be classified T4 如果侵犯覆盖胃韧带或网膜的脏层腹膜，则分期为T4
s74 Sentence Tumors from 3,665 patients were HER2 tested; of the patients, 810 were positive (22%) and 594 met eligibility criteria for randomization 此研究共有3,665例患者入组，810例患者HER2阳性（22%），594例符合入选标准接受随机分组
s75 Sentence There was no significant difference in rates of any adverse event, and cardio toxic effects were equally rare in both arms 两组的不良事件发生率无显著性差异，心脏毒性在两组中均罕见
s76 Sentence Neoadjuvant chemoradiation therapy as evidenced in the SWOG-S0425 trial, which is now closed, and the RTOG-9904 trial, which is now completed 已结束的SWOG-S0425和已完成的RTOG-9904临床研究推荐新辅助放化疗方案
s77 Sentence One of the following surgical procedures: Distal subtotal gastrectomy (if the lesion is not in the fundus or at the cardioesophageal junction) 进行以下一种手术：远端胃大部切除术（除外胃底或贲门食管交界处病变）
s78 Sentence The HR for death in the S-1 group, as compared with the surgery-only group, was 0.68 (95% CI, 0.52–0.87; P = .003) 与单纯手术组相比，S-1组死亡HR为0.68（95%CI：0.52-0.87；P=0.003）
s79 Sentence HER2 positivity was defined as either 3+ staining by IHC or a HER2 to CEP17 ratio of two or more using FISH 若患者IHC染色3+或FISH显示HER2比CEP17大于等于2，则认为此患者为HER2阳性
s80 Sentence A designation of pN0 should be used if all examined lymph nodes are negative, regardless of the total number removed and examined 如果所有淋巴结检测结果均为阴性，则无论切除与检测的淋巴结总数，均属于pN0期
s81 Sentence An international collaboration of investigators randomly assigned 445 patients with metastatic gastric cancer to receive docetaxel, cisplatin, and 5-FU (DCF) or CF 一项国际协作临床研究中445例转移性胃癌患者被随机分组接受多西他赛、顺铂联合5-FU的DCF化疗方案或者是CF方案治疗
s82 Sentence The group who received ECF had a significantly longer median survival (8.9 vs. 5.7 months, P = .0009) than the FAMTX group ECF组的中位生存时间明显长于FAMTX组（分别为8.9与5.7个月，P=0.0009）
s83 Sentence Trastuzumab, cisplatin, and either 5-FU or capecitabine in patients with HER2-positive tumors (3+ on immunohistochemistry [IHC] or fluorescence in situ hybridization [FISH]-positive) 对于HER-2阳性的患者（免疫组化[IHC]3+，或荧光原位杂交[FISH]阳性），使用曲妥珠单抗，顺铂并联合5-FU或卡培他滨中的一种
s84 Sentence The adjacent structures of the stomach include the spleen, transverse colon, liver, diaphragm, pancreas, abdominal wall, adrenal gland, kidney, small intestine, and retroperitoneum 胃周围结构包括脾脏、横结肠、肝脏、膈肌、胰腺、腹壁、肾上腺、肾、小肠、后腹膜
s85 Sentence If the lesion is not in the cardioesophageal junction and does not diffusely involve the stomach, subtotal gastrectomy is the procedure of choice 在肿瘤未累及贲门食管交界处，亦未弥漫累及全胃时应进行胃大部切除术
s86 Sentence The 3-year OS was 83% in the chemotherapy group and 78% in the surgery-alone group (HR, 0.72; 95% CI, 0.52–1.00; P = .0493) 化疗组的3年总生存率为83%，单纯手术组为78%（HR：0.72，95%CI：0.52-1.00；P=0.0493）
s87 Sentence Similarly, the incidence of gastroesophageal junction adenocarcinomas increased sharply, from 1.22 cases per 100,000 individuals (1973–1978) to 2.00 cases per 100,000 individuals (1985–1990) 同样的，食管胃交界部腺癌发病率也有显著上升，从1973-1978年的1.22/100,000人上升至1985-1990年的2.00/100,000人
s88 Sentence Although the treatment of patients with disseminated gastric cancer may result in palliation of symptoms and some prolongation of survival, long remissions are uncommon 对于弥漫性病变的胃癌患者，姑息治疗可缓解症状，延长生存时间，然而很少达到长期缓解
s89 Sentence When the lesion involves the cardia, proximal subtotal gastrectomy or total gastrectomy (including a sufficient length of esophagus) may be performed with curative intent 病变累及贲门时，为达到根治性目的，应进行近端胃大部切除术或全胃切除术（必须切除足够长的食管）
s90 Sentence Median survival was 36 months for the adjuvant chemoradiation therapy group as compared to 27 months for the surgery-alone arm ( P = .005) 联合放化疗组的生存时间中位数为36个月，单纯手术组则仅为27个月（P=0.005）
s91 Sentence Intramural extension to the duodenum or esophagus is classified by the depth of the greatest invasion in any of these sites, including the stomach 粘膜内浸润十二指肠或食管的分期取决于其中任一部位（包括胃）的最大侵犯深度
s92 Sentence Whether the CF regimen should be considered as an index regimen for the treatment of patients with metastatic gastric cancer is the subject of debate 对于转移性胃癌的患者，CF方案是否可作为参考方案仍有待进一步研究
s93 Sentence Five-year OS was 36.3%, 95% CI, 29 to 43 for the perioperative chemotherapy group and 23%, 95% CI, 16.6 to 29.4 for the surgery group 围手术期化疗组的5年总生存率为36.3%，95%CI为29%-43%；单纯手术组则为23%，95%CI为16.6%-29.4%
s94 Sentence The prognosis of patients with gastric cancer is related to tumor extent and includes both nodal involvement and direct tumor extension beyond the gastric wall 胃癌患者的预后与肿瘤累及范围相关，包括淋巴结受累和直接浸润穿透胃壁
s95 Sentence The 3-year disease-free survival rate was 74% in the chemotherapy group and 59% in the surgery-alone group (HR, 0.56; 95% CI, 0.44–0.72; P < .0001) 研究显示化疗组的3年无病生存率为74%，单纯手术组则为59%（HR：0.56，95%CI：0.44-0.72；P<0.0001）
s96 Sentence Neoadjuvant chemoradiation therapy such as in the RTOG-9904 trial, which is now completed, and the SWOG-S0425 (NCT00335959) trial, which is now closed, was clinically evaluated 新辅助放化疗的临床价值尚在接受临床评估，如已完成的RTOG-9904研究和已结束的SWOG-S0425（NCT00335959）临床研究
s97 Sentence As many as 15% of selected stage III patients can be cured by surgery alone, particularly if lymph node involvement is minimal (<7 lymph nodes) 至多15%的III期胃癌患者可单纯行手术治愈，特别是仅少量淋巴结转移者（<7个淋巴结）
s98 Sentence Five-year OS was 36.3%; 95% CI, 29 to 43 for the perioperative chemotherapy group and 23%; 95% CI, 16.6 to 29.4 for the surgery group 围手术期化疗组的5年总生存率为36.3%，95%CI为29%-43%；手术组则为23%，95%CI为16.6%-29.4%
s99 Sentence Total gastrectomy (if the tumor involves the stomach diffusely or arises in the body of the stomach and extends to within 6 cm of the cardia) 全胃切除术（若病变弥漫性累及全胃，或源于胃体并且向贲门远端弥漫不超过6cm）
s100 Sentence Since the prognosis is relatively favorable for patients with completely resected stage IB disease, the effectiveness of adjuvant chemoradiation therapy for this group is less clear 考虑到IB期患者全切术后预后相对较佳，辅助放化疗对于此分期的患者的作用目前不甚明确
s101 Sentence Experience in Japan, where stage 0 is diagnosed frequently, indicates that more than 90% of patients treated by gastrectomy with lymphadenectomy will survive beyond 5 years 日本的0期胃大量癌临床诊断经验表明，接受胃切除术与淋巴结清扫后，患者的5年生存率可达90%以上
s102 Sentence Neoadjuvant chemoradiation therapy remains under clinical evaluation, such as in the SWOG-S0425 (NCT00335959) trial, which is now closed and the RTOG-9904 trial, which is now completed 新辅助化疗的临床价值尚在接受临床评估，如已完成的RTOG-9904研究和已结束的SWOG-S0425（NCT00335959）临床研究
s103 Sentence Oxaliplatin and capecitabine are often substituted for cisplatin and 5-FU within the ECF regimen as a result of data from the REAL-2 trial ( ISRCTN51678883 ) 根据REAL-2临床研究（ISRCTN51678883）的结果，奥沙利铂与卡培他滨目前常用于替换ECF方案中的顺铂与5-FU
s104 Sentence A meta-analysis of these studies demonstrated an hazard ratio (HR) of 0.83 for overall survival (OS) (95% confidence interval [CI], 0.74–0.93) in favor of combination chemotherapy 一项荟萃分析显示，联合化疗相较于单一疗法具有相对优势，总生存率（OS）的危险比（HR）为0.83（95%可信区间[CI]：0.74-0.93）
s105 Sentence Neoadjuvant chemoradiation therapy has been under clinical evaluation, such as in the SWOG-S0425 (NCT00335959) trial, which is now closed, and the RTOG-9904 trial, which is now completed 新辅助放化疗正在进行临床评估，如已结束的SWOG-S0425和已完成的RTOG-9904临床研究
s106 Sentence Information about using the illustrations in this summary, along with many other cancer-related images, is available in Visuals Online , a collection of over 2,000 scientific images 关于使用本总结中图表和其他癌症相关图像的信息见在线图谱，在其中汇总了2000余幅科学图片
s107 Sentence The study treatment was administered every 3 weeks for six cycles, and trastuzumab was continued every 3 weeks until disease progression, unacceptable toxicity, or withdrawal of consent 患者每3周接受1次化疗，共6周期，同时每3周进行曲妥珠单抗给药，直至疾病进展、产生无法耐受的毒性反应或患者撤回知情同意书
s108 Sentence Median OS was 5.3 months in the group that received salvage chemotherapy and 3.8 months in the group that received best supportive care (HR, 0.657; P = .007) 补救性化疗组总生存时间中位数为5.3个月，最佳支持治疗组则为3.8个月（HR：0.657；P=0.007）
s109 Sentence There are changing epidemiologic patterns in the United States regarding the anatomic location of esophagogastric cancers, with a trend of decreased occurrence of distal or noncardia gastric cancers 近几十年来，美国人群中食管胃癌在不同部位的发病率不断改变，远端或非贲门癌的发病率有下降趋势
s110 Sentence Salvage chemotherapy consisted of either docetaxel (60 mg/m2 every 3 weeks) or irinotecan (150 mg/m2 every 2 weeks) and was left to the discretion of the treating physicians 补救性化疗由医生选择多西他赛（每3周60mg/m2）或伊立替康（每2周150mg/m2）中的一种
s111 Sentence Phase II studies evaluating irinotecan-based or oxaliplatin-based regimens demonstrate similar response rates and TTP to those found with ECF or CF, but the former may be less toxic II期临床研究显示，使用基于伊立替康或奥沙利铂的化疗方案后，患者反应率与TTP与行ECF或CF方案治疗的患者相似，且前者毒性反应更少
s112 Sentence Three-year overall survival (OS) and relapse-free survival rates were 50% and 48%, respectively, with adjuvant chemoradiation therapy versus 41% and 31%, respectively, for surgery alone ( P = .005) 联合放化疗组3年总生存率（OS）和无复发生存率分别为50%和48%，而单纯手术组为41%和31%（P=0.005）
s113 Sentence Total gastrectomy (if the tumor involves the stomach diffusely or arises in the body of the stomach and extends to within 6 cm of the cardia or distal antrum) 全胃切除术（若病变弥漫性累及全胃，或源于胃体并且向贲门或胃窦部远端弥漫不超过6cm）
s114 Sentence In a second trial that compared ECF with mitomycin, cisplatin, and 5-FU (MCF), there was no statistically significant difference in median survival (9.4 vs. 8.7 months, P = .315) 另一项研究比较了ECF方案与MCF方案（丝裂霉素、顺铂联合5-FU），两组患者的生存时间无统计学显著差异（分别为9.4与8.7个月，P=0.315）
s115 Sentence However, early-stage disease accounts for only 10% to 20% of all cases diagnosed in the United States. The remaining patients present with metastatic disease in either regional or distant sites 然而在美国，诊断时分期仍为早期胃癌者只占到所有胃癌病例的10%-20%，其余患者多已出现局部或远处转移灶
s116 Sentence Because distant disease remains a significant concern, the aim of the Cancer and Leukemia Group B study ( CALGB-80101 ) was to augment the postoperative chemoradiation regimen used in INT-0116 基于发生远处转移的重要意义，美国癌症与白血病B组研究（CALGB-80101）的目标是提高INT-0116所用术后放化疗剂量
s117 Sentence Three-year overall survival (OS) rates and relapse-free survival rates were 50% and 48%, respectively, with adjuvant chemoradiation therapy versus 41% and 31%, respectively, for surgery alone ( P = .005) 联合放化疗组3年总生存率（OS）和无复发生存率分别为50%和48%，而单纯手术组为41%和31%（P=0.005）
s118 Sentence With a median follow-up of 5 years, median survival was 36 months for the adjuvant chemoradiation therapy group as compared to 27 months for the surgery-alone arm ( P = .005) 在中位数为5年的随访期中，联合放化疗组的生存时间中位数为36个月，单纯手术组则为27个月（P=0.005）
s119 Sentence A tumor may penetrate the muscularis propria with extension into the gastrocolic or gastrohepatic ligaments, or into the greater or lesser omentum, without perforation of the visceral peritoneum covering these structures 原发病灶可穿透固有肌层，进入胃结肠或肝胃韧带，或大网膜、小网膜，但未侵犯覆盖这些结构的脏层腹膜
s120 Sentence Patients who received DCF experienced a significantly longer TTP (5.6 months; 95% CI, 4.9–5.9; vs. 3.7 months; 95% CI, 3.4–4.5; HR, 1.47; 95% CI, 1.19–1.82; log-rank P &lt; .001; risk reduction 32%) DCF组的患者TTP显著延长（DCF组5.6个月，95%CI：4.9-5.9；CF组3.7个月，95%CI：3.4-4.5；HR：1.47；95%CI：1.9-1.82；时序检验P&lt;0.001；风险减少32%）
s121 Sentence Median OS was 13.8 months (95% CI, 12–16) in patients assigned to trastuzumab and 11.1 months (95% CI, 10–13) in patients assigned to chemotherapy alone (HR, 0.74; 95% CI, 0.60–0.91; P = .0046) 曲妥珠单抗组的总生存时间（OS）中位数为13.8个月（95%CI:12-16），而单用化疗组为11.1个月（95%CI：10-13）（HR：0.74；95%CI：0.60-0.91；P=0.0046）
s122 Sentence Palliative chemotherapy with: Fluorouracil (5-FU) Epirubicin, cisplatin, and 5-FU (ECF) Epirubicin, oxaliplatin, and capecitabine (EOX) Cisplatin and 5-FU (CF) Docetaxel, cisplatin, and 5-FU Etoposide, leucovorin, and 5-FU (ELF) 5-FU, doxorubicin, and methotrexate (FAMTX) 姑息性化疗：氟尿嘧啶（5-FU）表柔比星，顺铂联合5-FU（ECF）表柔比星，奥沙利铂与卡培他滨（EOX）顺铂联合5-FU（CF）多西他赛，顺铂联合5-FU依托泊苷，亚叶酸钙联合5-FU（ELF）5-FU，多柔比星联合甲氨蝶呤（FAMTX）
s123 Sentence The results of a study that randomly assigned 245 patients with metastatic gastric cancer to receive CF, FAMTX, or ELF demonstrated no significant difference in response rate, progression-free survival, or OS between the arms 一项研究中，245例转移性胃癌患者被随机分组，分别接受CF、FAMTX或ELF方案治疗，研究结果显示三组的反应率、无进展生存率或总生存率（OS）无显著性差异
s124 Sentence Because distant disease remains a significant concern, the aim of the Cancer and Leukemia Group B study ( CALGB-80101 ), which is now closed, was to augment the postoperative chemoradiation regimen used in SWOG-9008 基于控制发生远处转移的重要意义，美国癌症与白血病B组研究（CALGB-80101）的目标是试图提高SWOG-9008试验中联合治疗所用术后放化疗剂量
s125 Sentence In an open-label, international phase III trial, patients with HER2-positive metastatic, inoperable locally advanced, or recurrent gastric or GE junction cancer were randomly assigned to chemotherapy with or without the anti-HER2 monoclonal antibody trastuzumab 在一项国际开放性III期临床研究中，HER-2阳性的转移性、局部晚期无法手术或复发性胃癌或胃食管交界处癌患者被随机分配至两组，分别使用添加或不添加抗HER2单克隆抗体曲妥珠单抗的化疗方案
s126 Sentence However, in persons aged 25 to 39 years, there has been a significant increase in the incidence of noncardia gastric cancers from 0.27 cases per 100,000 individuals (1977–1981) to 0.45 cases per 100,000 individuals (2002–2006) 但25-39岁人群中，非贲门胃癌的发病率已经从1977-1981年的0.27/100,000人上升至2002-2006年的每0.45/100,000人
s127 Sentence Febrile neutropenia was more common in patients who received DCF (29% vs. 12%), and the death rate on the study was 10.4% for patients on the DCF arm and 9.4% for patients on the CF arm DCF方案组更多观察到致热性中性粒细胞减少（分别为29%和12%），DCF方案组患者死亡率为10.4%，而CF方案组则为9.4%
s128 Sentence Radical surgery represents the standard form of therapy that has curative intent. However, the incidences of local failure in the tumor bed and regional lymph nodes, and distant failures via hematogenous or peritoneal routes, remain high 根治性手术时获得治愈的标准治疗模式，由于肿瘤复发或区域淋巴结转移而引起的局部治疗失败，以及由于血性转移或腹膜种植而引起的远处治疗失败，其发生率仍居高不下
s129 Sentence In contrast to the overall stable trend for noncardia gastric cancers, earlier studies demonstrated an increased incidence of adenocarcinomas of the gastric cardia of 4% to 10% per year from the mid-1970s to the late 1980s 与非贲门胃癌的发病率总体平稳不同，一些更早期研究显示，胃贲门腺癌的发病率从20世纪70年代中期至80年代后期每年增幅4%-10%
s130 Sentence Grades 3 and 4 neutropenia occurred in 35% to 43% of patients on all arms, but severe nausea and vomiting was more common in patients in the CF arm and occurred in 26% of those patients 三组患者出现3-4级中性粒细胞减少的比例均为35%-43%，而CF组严重恶心、呕吐的发生率更高，达26%
s131 Sentence During the last 20 years, multiple randomized studies evaluating different treatment regimens (monotherapy vs. combination chemotherapy) have been performed in patients with metastatic gastric cancer with no clear consensus emerging as to the best management approach 过去的二十年中，多项随机临床研究评估了不同治疗方案（单药化疗与联合化疗）对治疗方案尚存争议的转移性胃癌患者的效果
s132 Sentence The overall survival rate in these patients at 5 years ranges from almost no survival for patients with disseminated disease to almost 50% survival for patients with localized distal gastric cancers confined to resectable regional disease 胃癌患者总体5年生存率差异很大，出现转移者5年生存率几乎为零，而可切除的远端胃癌患者的生存率则可高达50%
s133 Sentence Investigators in Korea randomly assigned patients with advanced gastric cancer who had received one or two prior chemotherapy regimens involving both a fluoropyrimidine and a platinum agent to either salvage chemotherapy or best supportive care in a 2:1 fashion 韩国一项研究中，接受过1-2种化疗方案（含氟嘧啶与铂剂）的晚期胃癌患者以2：1比例被随机分配至两组，分别接受补救性化疗和最佳支持治疗
s134 Sentence More recent data demonstrate that the incidence of gastric cardia cancers has been relatively stable, although an increase has been observed, from 2.4 cases per 100,000 individuals (1977–1981) to 2.9 cases per 100,000 individuals (2001–2006) in the Caucasian population 最新数据显示虽然观察到胃贲门癌发病率略有上升，但总体相对平稳，高加索人群中，发病率从1977-1981年的2.4/100,000人上升至2001-2006年的2.9/100,000人
s135 Sentence The median OS was significantly longer for patients who received DCF versus patients who received CF (9.2 months; 95% CI, 8.4–10.6; vs. 8.6 months; 95% CI, 7.2–9.5; HR, 1.29; 95% CI, 1.0–1.6; log-rank P = .02; risk reduction = 23%) DCF组患者的总生存时间（OS）中位数明显长于CF组（DCF组9.2个月，95%CI：8.4-10.6；CF组8.6个月，95%CI：7.2-9.5；HR：1.29，95%CI：1.0-1.6；时序检验P=0.02；风险减少23%）
s136 Sentence Added text to state that in contrast to the overall stable trend for noncardia gastric cancers, earlier studies demonstrated an increased incidence of adenocarcinomas of the gastric cardia of 4% to 10% per year from the mid-1970s to the late 1980s 增加内容：与非贲门胃癌的发病率总体平稳不同，一些更早期研究显示，胃贲门腺癌的发病率从20世纪70年代中期至80年代后期每年增幅4%-10%
s137 Sentence Standard chemotherapy versus best supportive care for patients with metastatic gastric cancer has been tested in several clinical trials, and there is general agreement that patients who receive chemotherapy live for several months longer on average than patients who receive supportive care 多项临床研究验证了标准化疗和最佳支持疗法在治疗转移性胃癌中的效果，目前的共识认为接受化疗的患者平均生存时间较接受支持疗法的患者可延长数月
s138 Sentence If the lesion is not in the cardioesophageal junction and does not diffusely involve the stomach, subtotal gastrectomy is the procedure of choice, since it has been demonstrated to provide equivalent survival when compared with total gastrectomy and is associated with decreased morbidity 研究证实在肿瘤未累及贲门食管交界处，亦未弥漫累及全胃时首选胃大部切除术，其术后生存率与全胃切除术相当，但并发症相比减少
s139 Sentence Also added that the incidence of gastroesophageal junction adenocarcinomas increased sharply, from 1.22 cases per 100,000 individuals (1973–1978) to 2.00 cases per 100,000 individuals (1985–1990); and that since that time, incidence has remained steady, with an incidence of 1.94 cases per 100,000 individuals (2003–2008) 同样的，食管胃交界部腺癌发病率也有显著上升，从1973-1978年的1.22/100,000人上升至1985-1990年的2.00/100,000人；此后发病率基本稳定在1.94/100,000人（2003-2008年）
s140 Sentence A prospective multi-institution phase III trial ( SWOG-9008 ) evaluating postoperative combined chemoradiation therapy versus surgery alone in 556 patients with completely resected stage IB to stage IV (M0) adenocarcinoma of the stomach and gastroesophageal junction reported a significant survival benefit with adjuvant combined modality therapy 一项前瞻性多中心III期临床研究（SWOG-9008）评估了术后联合或不联合放化疗的手术治疗效果，共556例IB至IV（M0）胃和食管胃连接处腺癌患者入组，均行全胃切除术，研究表明接受辅助联合治疗的患者生存率显著升高
s141 Sentence More recent data demonstrate that the incidence of gastric cardia cancers has been relatively stable, although an increase has been observed, from 2.4 cases per 100,000 individuals (1977–1981) to 2.9 cases per 100,000 individuals (2001–2006) in the Caucasian population (cited Anderson et al. as reference 2) 最新数据显示虽然观察到胃贲门癌发病率略有上升，但总体相对平稳，高加索人群中，发病率从1977-1981年的2.4/100,000人上升至2001-2006年的2.9/100,000人
s142 Sentence A prospective multi-institution phase III trial ( SWOG-9008 ) evaluated postoperative combined chemoradiation therapy versus surgery alone in 556 patients with completely resected stage IB to stage IV (M0) adenocarcinoma of the stomach and gastroesophageal junction and reported a significant survival benefit with adjuvant combined modality therapy 一项前瞻性多中心III期临床研究（SWOG-9008）评估了术后联合或不联合放化疗的手术治疗效果，共556例IB至IV（M0）胃和食管胃连接处腺癌患者入组，均行全胃切除术，研究表明接受辅助联合治疗的患者生存率显著升高
s143 Sentence Japanese investigators randomly assigned 1,059 patients with stage II or III gastric cancer who had undergone a D2 gastrectomy to receive either 1 year of S-1, an oral fluoropyrimidine not available in the United States, or follow-up after surgery alone. Patients were randomly assigned in a 1:1 fashion 日本学者的一项临床研究招募了1,059例已行D2胃切除术的II期或III期胃癌患者，随机平均分配至两组，一组口服替吉奥（S-1，未进入美国市场的口服氟嘧啶药物）一年，另一组术后仅进行随访
s144 Sentence In the CLASSIC (NCT00411229) trial , 37 centers in South Korea, China, and Taiwan randomly assigned 1,035 patients with stage IIA, IIB, IIIA, or IIIB gastric cancer who had undergone a curative D2 gastrectomy to receive adjuvant chemotherapy (eight 3-week cycles of capecitabine plus oxaliplatin) or follow-up post-surgery alone 在CLASSIC（NCT00411229）临床研究中，来自韩国、中国和台湾37个中心的1,035例已行根治性D2胃切除术后的IIA、IIB、IIIA或IIIB期胃癌患者被分为两组，一组接受术后辅助化疗（奥沙利铂+口服8个疗程的卡陪他滨，每疗程3周），或仅接受术后随访
s145 Sentence In a phase III Intergroup trial ( SWOG-9008 ), 556 patients with completely resected stage IB to stage IV (M0) adenocarcinoma of the stomach and gastroesophageal junction were randomly assigned to receive surgery alone or surgery plus postoperative chemotherapy (5-fluorouracil [5-FU] and leucovorin) and concurrent radiation therapy (45 Gy) 根据一项III期临床研究（SWOG-9008），556位患IB至IV（M0）期的胃和食管胃交界处可切除腺癌的患者被随机分成两组，一组予以单纯外科手术治疗，另一组予以手术联合术后化疗（5-氟尿嘧啶[5-FU]与亚叶酸）合并放疗（45Gy）
s146 Sentence In the randomized phase III trial ( MRC-ST02 ), patients with stage II or higher adenocarcinoma of the stomach or of the lower third of the esophagus were assigned to receive three cycles of epirubicin, cisplatin, and continuous infusion 5-FU before and after surgery or to receive surgery alone 在一项III期随机临床试验（MRC-ST02）中，II期及以上的胃腺癌、食管下段三分之一腺癌的患者随机分配至两组，分别仅接受手术治疗或在术前、术后辅以3个疗程的表柔比星、顺铂并连续静注5-FU
s147 Sentence In the randomized phase III trial ( MRC-ST02 ), patients with stage II or higher adenocarcinoma of the stomach or of the lower third of the esophagus were assigned to receive three cycles of epirubicin, cisplatin, and continuous infusion 5-fluorouracil (ECF) before and after surgery or to receive surgery alone 一项III期随机临床试验（MRC-ST02）中，II期及以上的胃腺癌、食管下段三分之一腺癌的患者随机分配至两组，分为单纯手术治疗组及手术辅以手术前后3个疗程的表柔比星、顺铂并连续静注5-FU（ECF方案）
s148 Sentence Because distant disease remains a significant concern, the aim of the Cancer and Leukemia Group B study ( CALGB-80101 ), which is now closed, was to augment the postoperative chemoradiation regimen used in the SWOG-9008 trial, for example, and the preoperative chemotherapy and chemoradiation therapy regimen used, for example, in the RTOG-9904 trial, which is now completed 基于控制发生远处转移的重要意义，美国癌症与白血病B组研究（CALGB-80101）的目标是试图提高SWOG-9008试验中联合治疗所用术后放化疗剂量。新辅助化疗的临床价值尚在接受临床评估，如已完成的RTOG-9904研究
s149 Sentence This randomized trial of 1,002 patients with advanced esophageal, gastroesophageal (GE) junction, or gastric cancer utilized a 2 × 2 design to demonstrate noninferior median OS in patients treated with capecitabine rather than 5-FU (HR death = 0.86; 95% CI, 0.82–0.99) and in patients treated with oxaliplatin in place of cisplatin (HR death = 0.92; 95% CI, 0.80–1.10) 该随机研究共有1002例患有晚期食管、胃食管交界处或胃癌患者入组，研究使用2×2分组方案，显示卡培他滨治疗的患者中位总生存率不劣于5-FU治疗的患者（死亡率HR=0.86，95%CI：0.82-0.99），亦不劣于奥沙利铂取代顺铂治疗的患者（死亡率HR=0.92，95%CI：0.80-1.10）
s150 Sentence Added text to state that there are changing epidemiologic patterns in the United States regarding the anatomic location of esophagogastric cancers, with a trend of decreased occurrence of distal or noncardia gastric cancers; however, in persons aged 25 to 39 years, there has been a significant increase in the incidence of noncardia gastric cancers from 0.27 cases per 100,000 individuals (1977–1981) to 0.45 cases per 100,000 individuals (2002–2006) (cited Anderson et al. as reference 2) 增加内容：美国各解剖部位不同的食管-胃癌的流行病学不断变化，存在远端或非贲门胃癌发生率降低趋势，但25-39岁人群中非贲门胃癌发生率从0.27/100,000人（1977-1981年）上升至0.45/100,000人（2002-2006年）（引用Anderson等人文献，见参考文献2）