[Present status in the nationwide registration of gastric cancer]

The nationwide registration of gastric cancer was started in 1963 when about 6,000 cases were registered. Thereafter, the number of registered cases gradually increased and amounted to 200,000 in 1985. The frequency of detection of early gastric cancer among gastrectomized cases has steadily increased from 10% in 1963 to 30% in 1978. In particular, the increase in the incidence of early cancer with "m" depth is significant. The resection rate among all primary gastric cancer patients increased from 68% in 1963 to 83% in 1978, and the rate of total gastrectomy also increased from 14% to 23%. The operative direct death rate has decreased irrespective of the extent of gastrectomy. The relative 5-year survival rate of all primary cases was 29.8% in period [a] (1963-66), and 48.2% in period [C] (1974-78), with an increase in the rate of 18.4% over about 10 years. In the meantime, the rates of gastrectomized cases and those given macroscopic curative operation showed respective increases of 13.5% (from 44.3% to 57.8%) and 11.9% (from 60.8% to 72.7%). Improvement in the treatment results was more significant in advanced stage disease. The provisional TNM stage grouping was examined with the treatment results of 15,589 cases registered at member institutions of the Japanese Research Society For Gastric Cancer in period [B] (1969-73) and was shown to have marked irrationality. A more rational stage grouping was therefore devised and proposed and was wholly adopted by the UICC TNM Classification Committee in 1985.