老年胃癌术后腹膜转移综合管理

doi:10.3969/j.issn.1003-9198.2026.10.001

摘要/Abstract

摘要： 胃癌腹膜转移是老年胃癌患者术后最常见且预后最差的复发方式之一,严重影响患者生活质量与预后。由于衰弱、多病共存、营养不良及器官储备功能下降等原因,老年胃癌腹膜转移患者的诊疗较普通人群更具复杂性。本文围绕老年胃癌术后腹膜转移的综合管理,对近年来国内外相关研究进展进行综述,着重从危险因素识别、风险评估体系的构建到基于老年综合评估的分层管理综合治疗策略进行阐述。提出风险评估、精准分层、综合治疗与支持治疗相结合的全程管理模式,是优化老年胃癌术后腹膜转移患者治疗决策的重要方向。未来需进一步整合肿瘤生物学特征、老年综合评估及营养炎症指标等多维信息,建立适用于老年胃癌术后腹膜转移患者的精准管理体系,为临床个体化治疗提供参考。

关键词: 老年人, 胃癌, 腹膜转移, 综合管理, 预后

Abstract: Peritoneal metastasis is the most common pattern of postoperative recurrence and the leading cause of poor prognosis in older adults with gastric cancer, substantially compromising survival and quality of life. Owing to frailty, comorbidities, malnutrition, and reduced physiological reserve, the management of peritoneal metastasis in older patients is more challenging than that in the general population. This review summarizes advances in the comprehensive management of postoperative peritoneal metastasis in older adults with gastric cancer, with focus on risk factor identification, risk assessment systems, comprehensive geriatric assessment (CGA)-based stratified management, and multidisciplinary therapeutic strategies. Current evidence suggests that an integrated management approach combining risk assessment, individualized stratification, comprehensive treatment, and supportive care may optimize therapeutic decision-making and improve clinical outcomes in this population. Future research should further integrate tumor biological characteristics, CGA, nutritional and inflammatory biomarkers, and other multidimensional indicators to establish precision management models for older patients with post-gastrectomy peritoneal metastasis, thereby providing evidence to support individualized clinical management.

Key words: aged, gastric cancer, peritoneal metastasis, comprehensive management, prognosis

中图分类号:

R735.2

严齐, 雎巧月, 朱宏. 老年胃癌术后腹膜转移综合管理[J]. 实用老年医学, 2026, 40(10): 973-979.

YAN Qi, JU Qiaoyue, ZHU Hong. Multidisciplinary management of peritoneal metastasis after gastrectomy in older adults with gastric cancer[J]. Practical Geriatrics, 2026, 40(10): 973-979.

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