Stomach Carcinoma Surveillance Counterpoint: Japan

  • Yoshihiro KakejiEmail author
  • Masaru Morita
  • Yoshihiko Maehara
Part of the Current Clinical Oncology book series (CCO)


Gastric cancer was overtaken by lung cancer as the leading cause of cancer-related death in Japan in 1999. In 2007, it still accounted for 50,597 deaths (15 % of all deaths from cancer) [1]. The proportion of gastric cancers that are detected early through screening measures is now around 60 % in Japan. These patients require limited surveillance after primary treatment. A large proportion of patients still present with nonresectable tumors at the time of surgery. Those with advanced tumors resected with curative intent are the target of close follow-up.


Nonresectable tumor Japan Surveillance Endoscopy Recurrence 


  1. 1.
    Ministry of Health, Labor and Welfare, Japan. Figure for vital statistics in 2007. Available at: ( Accessed Jun 2011
  2. 2.
    Craanen ME, Dekker W, Blok P, Ferwerda J, Tytgat GN. Intestinal metaplasia and Helicobacter pylori: an endoscopic bioptic study of the gastric antrum. Gut. 1992;33:16–20.PubMedCrossRefGoogle Scholar
  3. 3.
    Nobuta A, Asaka M, Sugiyama T, et al. Helicobacter pylori infection in two areas in Japan with different risks for gastric cancer. Aliment Pharmacol Ther. 2004;20 Suppl 1:1–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Suzuki H, Iwasaki E, Hibi T. Helicobacter pylori and gastric cancer. Gastric Cancer. 2009;12:79–87.PubMedCrossRefGoogle Scholar
  5. 5.
    Uemura N, Mukai T, Okamoto S, et al. Effect of Helicobacter pylori eradication on subsequent development of cancer after endoscopic resection of early gastric cancer. Cancer Epidemiol Biomarkers Prev. 1997;6:639–42.PubMedGoogle Scholar
  6. 6.
    Fukase K, Kato M, Kikuchi S, et al. Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial. Lancet. 2008;372:392–7.PubMedCrossRefGoogle Scholar
  7. 7.
    The Japanese Gastric Cancer Association (JGCA). The first version of gastric cancer treatment guidelines. Available at: (
  8. 8.
    The Japanese Gastric Cancer Association. Guidelines for diagnosis and treatment of carcinoma of the stomach. April 2004 ed. Available at: (
  9. 9.
    Shimura T, Sasaki M, Kataoka H, et al. Advantages of endoscopic submucosal dissection over conventional endoscopic mucosal resection. J Gastroenterol Hepatol. 2007;22:821–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Gotoda T, Yanagisawa A, Sasako M, et al. Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer. 2000;3:219–25.PubMedCrossRefGoogle Scholar
  11. 11.
    Kojima K, Yamada H, Inokuchi M, Hayashi M, Kawano T, Sugihara K. Current status and evaluation of laparoscopic surgery for gastric cancer. Dig Endosc. 2008;20:1–5.CrossRefGoogle Scholar
  12. 12.
    Japan Society for Endoscopic Surgery. A questionnaire survey for endoscopic surgery. The report of the 9th meeting. J Jpn Soc Endosc Surg. 2008;13:525–529.Google Scholar
  13. 13.
    The Japanese Gastric Cancer Association Registration Committee. Gastric cancer treated in 1991 in Japan: data analysis of nationwide registry. Gastric Cancer. 2006;9:51–66.CrossRefGoogle Scholar
  14. 14.
    Ikeda Y, Saku M, Kishihara F, Maehara Y. Effective follow-up for recurrence or a second primary cancer in patients with early gastric cancer. Br J Surg. 2005;92:235–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Maehara Y, Tomisaki S, Emi Y, et al. Clinicopathological features of patients who died with second primary cancer after curative resection for gastric cancer. Anticancer Res. 1995;15:1049–54.PubMedGoogle Scholar
  16. 16.
    Yamamoto M, Yamanaka T, Baba H, et al. Postoperative recurrence and the occurrence of second primary carcinomas in patients with early gastric carcinoma. J Surg Oncol. 2008;97:231–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Sano T, Yamamoto S, Kurokawa Y, et al. D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer new eng. J Med. 2008;359:453.Google Scholar
  18. 18.
    Shirasaka T, Nakano K, Takechi T, et al. Antitumor activity of 1 M tegafur- 0.4 M 5-chloro-2,4-dihydroxy-pyridine- 1 M potassium oxonate (S-1) against human colon carcinoma orthotopically implanted into nude rats. Cancer Res. 1996;56:2602–6.PubMedGoogle Scholar
  19. 19.
    Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2007;357:1810.PubMedCrossRefGoogle Scholar
  20. 20.
    Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM. Gastric adenocarcinoma: review and considerations for future directions. Ann Surg. 2005;241:27–39.PubMedGoogle Scholar
  21. 21.
    Nakajima T, Yamaguchi T (eds). The gastric cancer registry database 1946-2004 (Cancer Institute Hospital gastric cancer database 1946–2004), Tokyo: Kanehara & Co., Ltd; 2006Google Scholar
  22. 22.
    Maehara Y, Hasuda S, Koga T, Tokunaga E, Kakeji Y, Sugimachi K. Postoperative outcome and sites of recurrence in patients following curative resection of gastric cancer. Br J Surg. 2000;80:353–7.CrossRefGoogle Scholar
  23. 23.
    Shiraishi N, Inomata M, Osawa N, Yasuda K, Adachi Y, Kitano S. Early and late recurrence after gastrectomy for gastric carcinoma. Univariate and multivariate analyses. Cancer. 2000;89:255–61.PubMedCrossRefGoogle Scholar
  24. 24.
    Takahashi Y, Takeuchi T, Sakamoto J, et al. The usefulness of CEA and/or CA19-9 in monitoring for recurrence in gastric cancer patients: a prospective clinical study. Gastric Cancer. 2003;6:142–5.PubMedCrossRefGoogle Scholar
  25. 25.
    Kim BS, Namkung S, Kim HC, Hwang IK, Hwang WC, Bae SH. CT findings of recurrent gastric carcinoma. Radiol. 2004;11:55–61.Google Scholar
  26. 26.
    Chen J, Cheong JH, Yun MJ, et al. The role of whole-body positron emission tomography with 18-fluorodeoxyglucose in recurrent gastric cancer. J Clin Oncol. 2004;22(14S):4065.Google Scholar
  27. 27.
    Cheon SH, Rha SY, Jeung HC, et al. Survival benefit of combined curative resection of the stomach (D2 resection) and liver in gastric cancer patients with liver metastases. Ann Oncol. 2008;19:1146–53.PubMedCrossRefGoogle Scholar
  28. 28.
    Sakamoto Y, Sano T, Shimada K, et al. Favorable indications for hepatectomy in patients with liver Metastasis from gastric cancer. J Surg Oncol. 2007;95:534–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Boku N, Yamamoto S, Shirao K, et al. Randomized phase III study of 5-fluorouracil (5-FU) alone versus combination of irinotecan and cisplatin (CP) versus S-1 alone in advanced gastric cancer (JCOG9912). Japan clinical oncology group trial. Proc Am Soc Clin Oncol. 2007;25:LBA4513 (abst)Google Scholar
  30. 30.
    Koizumi W, Narahara H, Hara T, et al. S-1plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9(3):215–21.PubMedCrossRefGoogle Scholar
  31. 31.
    Kakeji Y, Maehara Y, Sumiyoshi Y, et al. Angiogenesis as a target for gastric cancer. Surgery. 2002;131:S48–54.PubMedCrossRefGoogle Scholar
  32. 32.
    Yonemura Y, Fushida S, Bando E, et al. Lymphangiogenesis and the vascular endothelial growth factor receptor (VEGFR)-3 in gastric cancer. Eur J Cancer. 2001;37:918–23.PubMedCrossRefGoogle Scholar
  33. 33.
    Niki M, Toyoda M, Nomura E, et al. Expression of transforming growth factor beta (TGF-beta) may contribute, in part, to the variations in histogenesis and the prevalence of peritoneal dissemination in human gastric carcinoma. Gastric Cancer. 2000;3:187–92.PubMedCrossRefGoogle Scholar
  34. 34.
    Lee HS, Cho SB, Lee HE, et al. Protein expression profiling and molecular classification of gastric cancer by the tissue array method. Clin Cancer Res. 2007;13:4154–63.PubMedCrossRefGoogle Scholar
  35. 35.
    The Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma-2nd english edition-gastric cancer. 1998;1:10–24Google Scholar

Copyright information

© Humana Press 2013

Authors and Affiliations

  • Yoshihiro Kakeji
    • 1
    Email author
  • Masaru Morita
    • 1
  • Yoshihiko Maehara
    • 1
  1. 1.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

Personalised recommendations