Treatment of gastric cancer in Japan

Abstract

Although the incidence of gastric cancer has decreased because of the lower rate of Helicobacter pylori in-fection, it still accounts for a large number of deaths in Japan. Gastric cancer is mainly treated by resec-tion, and the rate of radical resection is high in Japan because approximately 50% of cases are diag-nosed at an early stage. Treatment advances have increased the number of endoscopic submucosal dis-sections, and development of laparoscopic surgery and robot-assisted surgery as minimally invasive ap-proaches has yielded results similar to those of conventional surgeries, at least in the short term. Cases for which resection is contraindicated are treated with chemotherapy if performance status can be main-tained. Although anticancer drugs are continuously under development, treatment outcomes remain un-satisfactory. As Japan becomes a super-aging society, the number of refractory cases is projected to in-crease. Therefore, evidence of any benefit for minimally invasive surgery and function-preserving surgery needs to be reported quickly. In this paper, we discuss gastric cancer treatment modalities recom-mended in the fifth edition of the gastric cancer treatment guidelines and describe recent research find-ings.