Evaluation of the Gastric Cancer Treatment Guidelines by the Japanese Gastric Cancer Association in the Clinical Practice Setting

Takashi Ichikura, Kentaro Chochi, Susumu Saigusa, Yoshihisa Yaguchi, Naoko Sakamoto and Hidetaka Mochizuki

Department of Surgery, I, National Defense Medical College Hospital

Background: It is unclear whether doctors are interested in or accept the gastric cancer treatment guidelines (GLs). We conducted a survey questionnaire to determine how GLs are evaluated by surgeons who treat patients with gastric cancer in Saitama Prefecture, including surgeons in smaller hospitals. Methods: A questionnaire concerning GLs was sent to chief surgeons of 105 hospitals in Saitama Prefecture, Japan, where surgery was routinely done under general anesthesia. Results: The incidence of respondents who had read none of the GLs was 5%and that of those reading them in part was 14%. The incidence of these answers together was significantly higher for institutions where fewer than 20 patients a year underwent gastric cancer surgery than for institutions where 20 or more patients a year underwent gastric cancer surgery. The indication of endoscopic treatment for early cancer, conservative D1+α /β gastrectomy for early cancer, and standard D2 gastrectomy for potentially curable advanced cancer were considered adequate by 80%, 69%, and 69% of respondents. Almost half of respondents answered that their treatment policy had not changed since GLs were published. Discussion: GLs are not sufficiently read or accepted by surgeons. It is therefore mandatory to ensure that surgeons who treat gastric cancer patients familiarize themselves with GLs. A wide range of opinions should be collected when GLs are revised.

Key words
gastric cancer treatment guidelines, questionnaire survey, smaller hospitals

Reprint requests
Takashi Ichikura Department of Surgery, I, National Defense Medical College Hospital
3-2 Namiki, Tokorozawa, 359-8513 Japan

Accepted
June 30, 2004

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