[Clinical impact of the Guidelines for Treatment of Gastric Cancer].

The first edition of the Guidelines for Treatment in Gastric Cancer (TGGC) was published in 2002 and it was revised in 2004. Those were the first Japanese treatment guidelines for any type of cancer. Questionnaires were then sent to committee members of the Japanese Gastric Cancer Association. After the responses had been analyzed, problems and improvements in the TGGC were discussed in comparison with the guidelines for cancer treatment in other organs. Based on the questionnaire results, the TGGC have been used sufficiently in clinical practice to serve as a standardized guide for gastric cancer treatment, and thus the initial aims of standardization of treatment and a common understanding among physicians and patients were achieved. The following problems and areas for improvement were pointed out: 1) Some standard treatments are described in the clinical trial setting. 2) The renewal for chemotherapy is not performed on the basis of new evidence. 3) The announcement of time and contents of new TGGC is necessary by internet. 4) An explanation of the objective index for evidence and recommendation levels is necessary, similar to those in the guidelines for the treatment of cancer in other organs. Japanese physicians have a responsibility to contribute to the evidence for gastric cancer treatment to be considered worldwide. In the near future, a simpler, more easily understandable revision of the TGGC will be necessary.