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Eto et al. J Cancer Metastasis Treat 2018;4:23                      Journal of Cancer
               DOI: 10.20517/2394-4722.2017.73                           Metastasis and Treatment




               Review                                                                        Open Access


               Treatment strategy for metastatic gastric cancer in
               Japan



               Kojiro Eto , Satoshi Ida , Masayuki Watanabe , Hideo Baba 2
                                   1
                        1
                                                      1
               1 Department of Gastroenterological Surgery, Cancer Institute Hospital, Koto-ku, Tokyo 135-8550, Japan.
               2 Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto
               860-0811, Japan.
               Correspondence to: Dr. Masayuki Watanabe, Department of Gastroenterological Surgery, Cancer Institute Hospital, 3-8-31,
               Ariake, Koto-ku, Tokyo 135-8550, Japan. E-mail: masayuki.watanabe@jfcr.or.jp
               How to cite this article: Eto K, Ida S, Watanabe M, Baba H. Treatment strategy for metastatic gastric cancer in Japan. J Cancer
               Metastasis Treat 2018;4:23. http://dx.doi.org/10.20517/2394-4722.2017.73
               Received: 20 Dec 2017    First Decision: 13 Mar 2018    Revised: 4 Apr 2018    Accepted: 23 Apr 2018    Published: 16 May 2018

               Science Editor: Lucio Miele    Copy Editor: Jun-Yao Li    Production Editor: Cai-Hong Wang


               Abstract
               Despite recent progress in diagnostic imaging, gastric cancer (GC) is occasionally found at an advanced stage with
               distant metastasis. As metastatic GC is difficult to cure, the treatment strategy should be considered individually based
               on the physical and socioeconomic status of patients as well as on the GC symptoms. The first choice of treatment for
               metastatic GC is chemotherapy, and several chemotherapeutic regimens for metastatic or recurrent GC have been
               developed through randomized controlled trials. Ongoing clinical trials will provide novel therapeutic options for patients
               with metastatic GC in the near future, while individualization of treatment based on detailed molecular information, so-
               called precision medicine, is eagerly anticipated. In this article, we review recent publications and guidelines focusing on
               recent progress in the treatment of metastatic GC in Japan.


               Keywords: Gastric cancer, chemotherapy, molecularly targeted drug, para-aortic lymph node metastasis, liver metastasis


               INTRODUCTION
               Gastric cancer (GC) is the fourth most commonly diagnosed cancer and the second leading cause of cancer
               mortality worldwide . A large-scale database analysis in the United States revealed that distant metastases
                                 [1,2]
               were present in 34% of GC patients at the time of their GC diagnosis . Although systematic screening
                                                                             [3]
               programs have been developed in Japan to enable detection of early stage GC , GC is occasionally found
                                                                                  [4]
               at an advanced stage with distant metastasis. The first choice of treatment for patients with metastatic GC
               is chemotherapy . Although recent advances in chemotherapy, including immune checkpoint inhibitors
                             [5]

                           © The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
                           International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
                sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
                as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
                and indicate if changes were made.


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