PDF(Pubmed)
Abstract：
Background: Despite the strong declining trends in incidence and mortality over the last decades, gastric cancer (GC) is still burdened with high mortality, even in high-income countries. To improve GC prognosis, several guidelines have been increasingly published with indications about the most appropriate GC management. The Italian Society of Digestive System Pathology (SIPAD) and Gastric Cancer Italian Research Group (GIRCG) designed a survey for both surgeons and patients with the purpose of evaluating the degree of application and adherence to guidelines in GC management in Italy. Materials and Methods: Between January and May 2022, a questionnaire has been administered to a sample of Italian surgeons and, in a simplified version, to members of the Patient Association \"Vivere Senza Stomaco\" (patients surgically treated for GC between 2008 and 2021) to investigate the diagnosis, staging, and treatment issues. Results: The survey has been completed by 125 surgeons and 125 patients. Abdominal CT with gastric hydro-distension before treatment was not widespread in both groups (47% and 42%, respectively). The rate of surgeons stating that they do not usually perform minimally invasive gastrectomy was 15%, but the rate of patients who underwent a minimally invasive approach was 22% (between 2011 and 2022). The percentage of surgeons declaring to perform extended lymphadenectomy (>D2) was 97%, although a limited lymph node dissection rate was observed in about 35% of patients. Conclusions: This survey shows several important discrepancies from surgical attitudes declared by surgeons and real data derived from the reports available to the patients, suggesting heterogeneous management in clinical practice and, thus, a not rigorous adherence to the guidelines.
摘要：
背景：尽管在过去的几十年中，发病率和死亡率呈强劲下降趋势，胃癌（GC）仍然是高死亡率的负担，即使是在高收入国家。为了改善GC预后，一些指南已经越来越多地发布，并有关于最合适的GC管理的适应症。意大利消化系统病理学学会（SIPAD）和胃癌意大利研究小组（GIRCG）为外科医生和患者设计了一项调查，目的是评估意大利GC管理指南的应用程度和遵守程度。材料与方法：2022年1月至5月，对意大利外科医生样本进行了问卷调查，在简化版本中，向患者协会“VivereSenzaStomaco”成员（2008年至2021年间接受GC手术治疗的患者）调查诊断，分期,和治疗问题。结果：该调查已由125名外科医生和125名患者完成。治疗前腹部CT伴胃液扩张在两组中并不普遍(47%和42%,分别)。外科医生表示他们通常不进行微创胃切除术的比率为15％，但接受微创方法的患者率为22%(2011年至2022年).宣布进行扩展淋巴结清扫术（>D2）的外科医生百分比为97％，尽管在约35％的患者中观察到淋巴结清扫率有限。结论：这项调查显示了外科医生宣布的手术态度与患者可获得的报告中的真实数据之间的几个重要差异，建议在临床实践中进行异质管理，因此，不严格遵守准则。
