我国胃癌治疗现状.pptxVIP

Challenge for Surgeons in CHINACurrent situation and future trendsJiafu Ji MD, PhD, FACSTumor burdenChina: 454,014 /yearGlobal: 1,034,124 /year2012325k667k203543.9%3% per yearKanagawa Cancer Center, JapanTimeStomachEGJ1986-199075.83.51991-199576.34.51996-200076.24.22001-200574.83.6Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray, F.GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet].Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed on day/month/year.Economical BurdenHigh ExpensePrice of treatment：Surgery+Chemo≈160k/人=23years’income for a rural labor「Catastrophic Expenditure 」Great Cost￥209 BillionEstimate annual economic loss韩启德 关于医学技术发展的价值思考Chinese featureMGC 31.2%EGC 10.8%Locally Advanced GC58.0%Less EGC, More LAGCD2 gastrectomyMDTLaparoscopyMore positive strategyStandard procedureWell acceptedWidely promotedCSCO. Gastric Cancer Survey.2011Endoscopic ultrasoundEnhanced CTTanyNanyM1T1N0T2+\N+EMR/ESD/Laparoscopic assisted radical gastrectomy/Standard radical gastrectomyDiagnosticLaparoscopyExperimental/Palliative/Optimal supportive careM0Surgery + perioperative adjuvant therapyTreatment algorithm in PKUCH1.8%20.5%77.6%Data from PKUCH, 2013.8-2014.9Pathologically confirmed gastric cancerMDT-Digital managementSurgery for EGCTherapeutic options of EGCEMR/ESD39.5%The Trends of EMR/ESD in Beijing Cancer Hospital, 2011-2013LAP29.9%OP30.7%Annual Growth: 22%Expanding boundary of ESDVideo: PKUCH, Department of EndoscopyNew challengeThe renovation of treatment strategy demands for better Accuracy and Comprehensiveness in clinical stagingpN+——8.2%pT1——88.7%Data from PKUCH, 2013.8-2014.9Current trends: SLN NavigationEndoscopic Dual-tracer1.Te99: 1day before surgery2.Dye: during surgeryAccuracy: 99%SN(-)/non-SN(+)→1%JCOG 0302Dye through serosa46.4%missed pN+*“Sentinel Lymph Node Biopsy”[mesh] Node“Stomach Neoplasms”[m