[Contradictions in Japanese classification of gastric carcinoma (JCGC) and a proposal for revision].

In today's rapid advancement in gastric cancer research, the role played by the JCGC is considerable. On the other hand, there are fundamental contradictions, and they will definitely present problems for research in the future. In this paper, these points were clarified, and a proposal for their revision was made. The contradictions are as follows: 1) lymph node grading based on the removal effect; 2) variable and inconsecutive grading according to the location of the primary lesion; 3) lymph node grading that assumes distal gastrectomy in lower or middle part of cancer; and 4) changing not only the location category but also the station to be dissected at each revision. To assure that the rule book will be accepted by many medical practitioners, it is important to clearly separate it from the role of a clinical guideline. This writer proposes that the JCGC classification must be revised in conformity with the TNM classification for a global standard and there must be cooperation in improving the clinical guideline regarding rules such as those for lymph node dissection.