Review of IV version of Japanese gastric cancer treatment guidelines

Lukashenko A., Boiko A.V. , Koshubarova M.V.

Summary. Gastric cancer (GC) takes one of the first places in cancer-related death. It is the fifth most frequently diagnosed cancer worldwide and the third leading cause of death from cancer. GC is classified as a tumor of a poor prognosis. Many patients have inoperable disease at diagnosis or have recurrent disease after resection with curative intent. In most cases inoperable GC is detected, the risk of recurrence is high even in the treatment of early stages. The incidence of GC remains high in Ukraine, 59.4% of patients are living less than one year after their initial diagnosis. The prevalence of incidence of GC in Japan, relatively high experience of surgeons compared with the Western world, where in most countries, including the US, GC is a rare disease, was the basis for the publication of this review of the IV english-language edition of the Japanese gastric cancer treatment guidelines. These treatment guidelines are based on results of randomized control trials and consensus among professional associations. Several advances have been made in the staging procedures, imaging techniques, and treatment approaches in fourth edition. In order to provide optimal clinical pathway teams of experts from different disciplines should be involved, surgery is the only curative treatment of GC. For locally advanced disease, adjuvant or neoadjuvant therapy is usually implemented in combination with surgery. In metastatic disease, outcomes are poor, with median survival being around 1 year. Major points of revision in the current version are: the section on types and definitions of gastric surgery, first time laparoscopic distal gastrectomy for clinical stage I cancer was recomended as treatment of choice, a revision was made in curative resection among tumors for endoscopic resection. The Japanese Gastric Cancer Association issued the IV edition of Japanese gastric cancer treatment guidlelines to provide a common basis of understanding of the extent of disease and selection of proper treatment among doctors, patients, their families and optimization in proper treatment of disease.
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