Dr Zilberstein: Brazil is a very large country. In the University， we advocate and utilize the Japanese guidelines. We think in this way we can obtain much better results. The Japanese guidelines have strong basic and scientific evidence that allows us to say that this procedure is much better than any other. We have to consider anyway that patients are different in different parts of the world. We have more advanced cancers and more overweight patients for example， so applying a defined procedure becomes more difficult. As a result， we have different procedures and we have a tailored procedure for gastric cancers. When necessary， adjuvant or neo-adjuvant chemotherapy can be very useful， but the rule is to always perform a very extensive gastric cancer surgery to provide better results. We strongly support the Japanese guidelines in this sense.

 

　　Dr Zilberstein：巴西是一个非常大的国家，在大学里我们提倡并使用日本的指南。我们认为通过这种手术方式可以获得更好的疗效。日本的指南有很牢固的基础和科学依据，因此我们认为这种手术方式比其他的手术方式要好得多。但不管怎样，我们必须考虑到世界上不同地区的患者各不相同。例如，我们有更多的晚期癌症患者和肥胖患者，因此应用一个限定的手术就变得更加困难。所以，我们就有许多不同类型的手术，有专门为胃癌制定的手术。必要时，辅助或新辅助化疗是非常有用的，但原则还是开展广泛性的胃癌切除术以提供更好的预后。在这点上我们强烈支持日本的指南。

 

　　Oncology Frontier: There is an increasing push for neo-adjuvant chemotherapy in the treatment of advanced gastric cancer. What are your views on that?

 

　　《肿瘤瞭望》：对于晚期胃癌的治疗，新辅助化疗的呼声日渐增多，对此您怎么看？

 

　　Dr Zilberstein: Surgery is always the best option. Chemotherapy depends on the drug utilized. So we need to analyze different situations in different places as surgery has its limits. We have been and are doing our best with surgery and we sometimes need more help to improve outcomes. So neo-adjuvant or adjuvant chemotherapy can help more in the future to produce better outcomes with gastric cancer.

 

　　Dr Zilberstein：手术一直是胃癌治疗的最佳选择，化疗依赖于所使用的药物。由于手术治疗有其局限性，因此我们在不同时期需要分析不同的情况。我们已经并且将会继续努力做好手术治疗，但有时我们需要更多的帮助去改善预后，因此新辅助化疗或辅助化疗能够在未来为胃癌患者提供更好的预后。