Review of the 5th edition of the Japanese gastric cancer treatment guidelines

Lukashenko A., Shipko A., Ostapenko Y. , Minich A., Cherchenko K.

Summary. Stomach cancer (SC) remains a critical issue in present-day oncology. In Ukraine, more than 4500 citizens die due to this disease each year. Around the world, SC holds sixth place in the structure of oncopathology incidences and fifth place in the causes of death from cancer. The onco-epidemiological specificity of SC produces a significant difference between the Eastern and Western worlds, so Japan registers one of the largest numbers of new cases of SC — up to 130 000 per year, which is a rate of 31.6 per 100 000 inhabitants, but simultaneously, it also registers the lowest mortality rate — 8.2 per 100 000 inhabitants, which indicates notable progress in the treatment of SC in this country. In comparison, in Ukraine in 2020, the incidence rate of SC was 9.1 per 100 000 inhabitants (6072 new cases registered), the mortality rate was 12.1 per 100 000 inhabitants and 52.8% of patients passed away within one year of diagnosis. In order to improve the diagnosis and treatment results of SC, the search for optimal algorithms to provide medical care to this category of patients continues. After the publication of a preliminary review of the 2014 edition of the Japanese guidelines for the treatment of SC, several pivotal randomized trials of the surgical treatment of this disease were obtained, including the results of large prospective studies focused on endoscopic surgical interventions. In the field of drug treatment for SC, the results of clinical experiments of new antitumor agents have led to important changes in clinical recommendations regarding the choice of combined regimens. The presented review of the fifth edition of the Japanese guidelines for the treatment of SC is focused on changes to the previous version, taking into account the data of the latest clinical studies.

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