[Chronological trends in gastric cancer surgery in Japan]

The development of surgery for gastric cancer in Japan was reviewed. Recently, favorable long-term results have been obtained in surgically treated gastric cancer patients. This success has been mainly attributable to the performance of extended lymph node removal since the 1960s and of active total gastrectomy since the 1950s. Furthermore, gastrectomy combined with the resection of other organs since the 1960s, has resulted in an improvement of resectability. On the other hand, modified lymph node removal for early gastric cancer has been promoted in the 1980s. With the progress of anticancer chemotherapy since the 1970s, the concept of reduction surgery has been introduced into cancer surgery, and active palliative gastrectomy has been performed. Despite the advances made in gastric cancer surgery, however, there is a definite limit to the surgical treatment of gastric cancer. For this reason, multidisciplinary therapy combined with surgery should be considered.