[Evaluation of cancer treatment by autopsy]

Various indices such as tumor markers, X-ray figures and variation of leucocyte count and body weight, are used for objective evaluation of cancer treatment in clinical medicine. On the other hand, autopsy does not provide exact evaluations in this sense. However, our analysis of 105 cancer autopsy cases revealed that autopsy helped to resolve 94.9% of the problems raised in clinical medicine: 94.9% having regard to primary and metastatic tumors, 45.7% with complicating diseases and cause of death 13.3% with appropriateness of diagnosis, and another 13.3% with suitability of treatment. To recover the position of autopsy in medicine, it is important to restore "science" in pathology by incorporating modern scientific methods and by logical analyses of exact findings obtained at autopsy. For this purpose, autopsy findings must be categorised and coded rather than descriptive. On the other hand, it is important to satisfy the clinical side by responding to the needs of rapidly advancing clinical medicine. For this purpose, especially in Japan where there is a shortage of pathologists in medical schools and hospitals, it is essential to involve clinical staffs, postgraduate students, and clinical residents in analysis of autopsy cases.