Review of the VII edition of the Japanese gastric cancer treatment guidelines

Lukashenko A. , Cherchenko K., Ostapenko Y. , Patsko V. , Razumeiko I.

Summary. Gastric cancer (GC) is a disease that has significant differences in morbidity and mortality rates depending on the part of the world, which can be more than 40 times between certain countries. The main percentage of new patients are registered in the Eastern Asia: South Korea, China, Japan, etc. Accordingly, these countries have highly specialized directions in the treatment of GC and a long-term positive experience of implementing screening programs. Screening in the developed countries of the East has changed the structure of the incidence of GC, for example in Japan — the detection of early GC became in more than half of primary cases. That significantly increased the percentage of patients who are completely cured of GC, and the treatment is dominated by minimally traumatic approaches of minimally invasive surgery. In 2023, GC was the third in the structure of cancer mortality worldwide, the annual incidence was 1.1 million new cases of GC, with a prognosis to increase to 1.8 million in 2040. In Ukraine, more than 4000 citizens died from cancer in 2022, the incidence rate was 9.2 per 100 000 population (6145 new cases), the mortality rate was 6.7 per 100 000 population, 48% of patients died within 1 year of diagnosis. For comparison, the incidence rate of GC in Japan is one of the lowest in the world — 31.6 per 100 000 population, the mortality rate is three times lower — 8.2 per 100 000 population, which indicates the high effectiveness of anti-cancer actions against cancer developed by Japanese specialists. After the publication of the previous review of the Japanese guidelines for the treatment of GC in 2018, the results of several key randomized trials on the surgical treatment of GC were obtained, including those focused on minimally invasive endoscopic, laparoscopic, robotic operations. In the directions of drug treatment of RS, The results of clinical trials with new antitumor drugs led to significant changes in clinical recommendations for the selection of new regimens and also included immunotherapy. The presented review of the sixth edition of the Japanese guidelines for the treatment of GC is focused on changes to the previous version, taking into account the data of the latest clinical studies.

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