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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
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