Trend in gastric cancer：35 years of surgical experience in Japan

AIM：To investigate the trend in gastric cancer surgery in the context of rapid therapeutic advancement in Japan and East Asia.METHODS：A retrospective analysis was performed on 4163 patients who underwent gastric resection for gastric cancer with histological confirmation between 1971 and 2007 at the...

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Published inWorld journal of gastroenterology : WJG Vol. 17; no. 29; pp. 3390 - 3397
Main Authors Yamashita, Keishi, Sakuramoto, Shinichi, Nemoto, Masayuki, Shibata, Tomotaka, Mieno, Hiroaki, Katada, Natsuya, Kikuchi, Shiroh, Watanabe, Masahiko
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 07.08.2011
Subjects
Gastrectomy
Humans
Japan - epidemiology
Original
Prognosis
Retrospective Studies
Stomach Neoplasms - diagnosis
Stomach Neoplasms - epidemiology
Stomach Neoplasms - mortality
Stomach Neoplasms - surgery
发病期间
发病率
大学医院
干预措施
手术切除
日本
死亡率
胃癌
Japan
Histology
Prognosis
Clinical classification
Age factors
Gastric cancer
Disease progression
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Summary:AIM：To investigate the trend in gastric cancer surgery in the context of rapid therapeutic advancement in Japan and East Asia.METHODS：A retrospective analysis was performed on 4163 patients who underwent gastric resection for gastric cancer with histological confirmation between 1971 and 2007 at the surgical unit in Kitasato University Hospital,to determine the trend in gastric cancer requiring surgery.RESULTS：Gastric cancer requiring surgical resection increased in our hospital,but the incidence adjusted for population was constant during the observed pe-riod.Interestingly,the ratio of diffuse type/intestinal type gastric cancer was unexpectedly unchanged,and that of advanced/early gastric cancer（EGC）was,however,markedly reduced,while the actual incidence of potentially curative advanced gastric cancer tended to decrease.The incidence of EGC requiring surgery tended to increase as a whole,which is consistent with increased prevalence of endoscopic surveillance.As a result,overall survival and mortality of gastric cancer requiring gastric resection has recently markedly improved.CONCLUSION：In Japan,planned interventions may improve surgical gastric cancer mortality,but an unexpected trend of persistent existence of intestinal type cancer suggests the need for more robust medical intervention.
Bibliography:AIM：To investigate the trend in gastric cancer surgery in the context of rapid therapeutic advancement in Japan and East Asia.METHODS：A retrospective analysis was performed on 4163 patients who underwent gastric resection for gastric cancer with histological confirmation between 1971 and 2007 at the surgical unit in Kitasato University Hospital,to determine the trend in gastric cancer requiring surgery.RESULTS：Gastric cancer requiring surgical resection increased in our hospital,but the incidence adjusted for population was constant during the observed pe-riod.Interestingly,the ratio of diffuse type/intestinal type gastric cancer was unexpectedly unchanged,and that of advanced/early gastric cancer（EGC）was,however,markedly reduced,while the actual incidence of potentially curative advanced gastric cancer tended to decrease.The incidence of EGC requiring surgery tended to increase as a whole,which is consistent with increased prevalence of endoscopic surveillance.As a result,overall survival and mortality of gastric cancer requiring gastric resection has recently markedly improved.CONCLUSION：In Japan,planned interventions may improve surgical gastric cancer mortality,but an unexpected trend of persistent existence of intestinal type cancer suggests the need for more robust medical intervention.
Keishi Yamashita,Shinichi Sakuramoto,Masayuki Nemoto,Tomotaka Shibata,Hiroaki Mieno,Natsuya Katada,Shiroh Kikuchi,Masahiko Watanabe（Department of Surgery,Kitasato University School of Medicine,Kitasato 1-15-1,Minami-ku,Sagamihara,Kanagawa 252-0374,Japan）
Histology; Age factors; Clinical classification; Prognosis; Disease progression; Gastric cancer
14-1219/R
ObjectType-Article-1
SourceType-Scholarly Journals-1
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Telephone: +81-42-7788111 Fax: +81-42-7789564
Author contributions: Yamashita K contributed to study design, acquisition of data, analysis, interpretation of data, drafting and critical revision of the article; Sakuramoto S contributed to study design, acquisition of data, analysis, interpretation of data, drafting and critical revision of the article; Nemoto M, Shibata T, Mieno H, Katada N and Kikuchi S contributed to study design and acquisition of data; Watanabe M contributed to study design, and gave final approval of the version to be published.
Correspondence to: Masahiko Watanabe, MD, PhD, FACS, Professor, Department of Surgery, Kitasato University School of Medicine, Kitasato-1-15-1, Sagamihara, Kanagawa 228-8555, Japan. gekaw@med.kitasato-u.ac.jp
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v17.i29.3390