PROLONGED SURVIVAL OF STOMACH-CANCER PATIENTS AFTER EXTENSIVE SURGERY AND ADJUVANT TREATMENT - AN OVERVIEW OF THE JAPANESE EXPERIENCE

The 5-year survival rate of resected stomach cancer patients, which had been nearly 20% or less in the 1950s, has now been increased to more than 60%. Such a remarkable improvement was analyzed from the data of the National Registry or of the nationwide cohort studies. Standardization of the operative method involving extensive lymph node dissection, which has prevailed since the mid-1960s, was the leading factor in this improvement. Development of improved techniques for early diagnosis increased the rate of detection of early cancer and the rate of early cancer per resected cases amounts to more than 30% in major institutions as of 1981. Adjuvant chemo-immunotherapy administered over a long postoperative period was confirmed to elevate the cure rate substantially. As new anticancer drugs recently developed in Japan, UFT (Uracil/Tegafur mixture) and HCFU (Carmoful) were introduced. Optional use of regional therapy such as arterial infusion chemotherapy or intracavital biological response modifiers (BRM) injection are among the latest treatment possibilities.