| [ Summary ] |
The merits and problems with Gastric Cancer Treatment Guidelines were investigated in relation to the aspects of both social and clinical issues. Regarding the social issues, the guidelines may have an influence on the following; a) standardization of the mode of treatment, b) mutual understanding between clinicians and patients, c) policies of medical insurance systems, and d) decision making in relation to litigation. Regarding clinical issues, when the indications of guidelines are considered based on the daily medical practices, each point of guidelines seems to be generally acceptable and useful. The indications for EMR or minimally invasive surgery should be regulated strictly as determined by the guidelines. Those for standard radical gastrectomy should be applied more broadly and flexibly, and those for extended radical gastrectomy should be maintained as a matter of sophisticated clinical investigation, performed in selected surgical institutions. |