[In regard to gastric cancer treatment guidelines--a revised edition].

The Japanese Gastric Cancer Association issued a revised edition of gastric cancer treatment guidelines in April 2004. Distinctive features of this revision are adopting newly published literatures after the first edition of the guidelines, laparoscopy-assisted gastrectomy and perioperative management, and illustrating evidence levels in the clinical study of chemotherapy. The treatment protocol of the phase III study is an actual example of this. Gastric cancer treatment in Japan leads the world when considering operation and endoscopic treatment. However, there are only few controlled randomized clinical trials in Japan, and many low quality literatures. On the other hand, an evaluation of the consensus of gastric cancer treatment indicates that it is a high evidence level. Furthermore, a revised edition of chemotherapy was the only one that could be able to show a high evidence level. According to a questionnaire investigation of the revised guidelines, more than 90% of the respondents (the members of Japanese Gastric Cancer Association) have used the guidelines. Hence, the role of the guidelines is important.