LAUSR

The 5th edition of the Japanese Gastric Cancer Treatment Guidelines was completed in January 2018, incorporating new evidence that emerged after publication of the previous edition. Information on some of the new evidence had already been delivered as quick bulletins in the website of the Japanese Gastric Cancer Association (JGCA) to supplement the previous edition. Prior to the initiation of editing process, concept and style of the new edition were reconsidered by the committee members. A survey participated by the entire member of the JGCA regarding the style of the treatment guidelines revealed that the members preferred the conventional textbook style as a format of the new treatment guidelines. However, the current trend of guideline editing as observed in guidelines for other types of cancer is strongly influenced by the Medical Information Network Distribution Service (MINDS) which has established a clear definition of the guidelines, and created and publicized standard methodology for their compilation. Thus, the committee members created several relevant Clinical Questions (CQ) and attempted to provide the best possible answers accompanied with detailed explanations, including the levels of evidence and the strength of recommendations. Besides adhering to the philosophy of our senior members who compiled the first edition which was the first of the cancer guidelines issued in Japan, the current committee members made attempts to incorporate the methodology established by the MINDS. Consequently, there might be more drastic changes in the structure and style in the upcoming revision. After publication of the previous edition in 2014, several pivotal randomized studies on surgery along with a prospective confirmative study focused on the endoscopic resection have been published. In the field of chemotherapy, emergence of new anti-cancer agents led to impressive increase in the options for therapeutic regimens. Therefore, considerable amount of revision was needed to compile the current version. Major points of revision in the current edition are listed below: