Japanese Staging System for Gastric Cancer: Evaluation and Documentation of Tumor Extension

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Abstract
A staging system was proposed in the ‘General Rules for Gastric Cancer Study’ published by the Japanese Research Society for Stomach Cancer in 1962. On the basis of the general rules, high-quality data on 132,379 patients with gastric cancer were collected. Statistical analysis of these data (10,812 resected cases in 1969–1973) showed several contradictions between stagings and survival rates, both in the Japanese staging and the present TNM staging of the UICC and the American Joint Committee (AJC). A new and unified staging system was completed by the UICC, the AJC, and the Japanese Joint Committee (JJC) to remove such contradictions, eliminate confusion caused by different systems, and introduce the most recent progress in diagnosis and treatment of gastric cancer. The most remarkable progress was ultrasound examination in the evaluation of tumor extension and the use of computer in the documentation and analysis of the data.

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