Abstract：
Radical gastrectomy is a mainstay therapy for patients with locally resectable gastric cancer (GC). GC patients who are candidates for radical gastrectomy will experience at least part of the following perioperative events: surgery, anesthesia, pain, intraoperative blood loss, allogeneic blood transfusion, postoperative complications, and their related anxiety, depression and stress response. Considerable clinical studies have shown that these perioperative events can promote recurrence and decrease the long-term survival of GC patients. The mechanisms include activation of neural signaling and the inflammatory response, suppression of antimetastatic immunity, increased release of cancer cells into circulation, and delayed adjuvant therapy, which are involved in every step of the invasion-metastasis cascade. Having appreciated these perioperative events and their influence on the risk of GC recurrence, we can now use this knowledge to find strategies that might substantially prevent the deleterious recurrence-promoting effects of perioperative events, potentially increasing cancer-free survival in GC patients.
摘要：
根治性胃切除术是局部可切除胃癌（GC）患者的主要治疗方法。胃癌根治术的患者将经历至少部分以下围手术期事件：麻醉,疼痛,术中失血,异体输血,术后并发症,和他们相关的焦虑，抑郁和应激反应。大量的临床研究表明，这些围手术期事件可以促进GC患者的复发并降低其长期生存率。机制包括神经信号的激活和炎症反应，抑制抗转移免疫，增加癌细胞向循环中的释放，和延迟辅助治疗，参与侵袭转移级联的每一步。认识到这些围手术期事件及其对GC复发风险的影响，我们现在可以利用这些知识来寻找可能基本上防止围手术期事件有害的复发促进效应的策略。可能增加GC患者的无癌生存率。
