Hope from Japan for esophagogastric cancers: esophagectomy and endoscopic submucosal dissection for gastric tube cancer

Excerpt

Westerns surgeons, oncologists, and pathologists are debating: Can the excellent results from early detection and treatment of tumors in the upper gastrointestinal tract reported from Japan and other Asian countries be achieved in the U.S. or Europe? Various reasons have been given to explain the poor survival of patients with gastric and esophageal cancers in the West. Some questions such as what are the effects of the biological, genetic, and molecular differences of cancer genomes between Asian and European ancestry patients remain unanswered. However, these cancer genome differences may only partly explain the better oncological outcomes of Japanese patients. In fact, we in the West should learn from our colleagues in Japan to make better use of screening programs, standardized D2 surgery for gastric cancer, and surveillance after treatment. An example of good practice is the recent 70% 5-year survival rate in advanced stages II and III gastric cancer patients reported by a large-scale multicenter randomized controlled trial in Japan [1, 2]. Therefore, the previous criticism that Japanese studies are limited by the retrospective nature of their analyses and should be considered with caution should now clearly be revised. …