Trend in gastric cancer: 35 years of surgical experience in Japan

Figure 1 Trends in gastric cancer patients in Kitasato University Hospital. A: Trend in the numbers of patients requiring surgery, according to 3 histology categories, namely intestinal, mixed, and diffuse type; B: Trend in the proportion of intestinal type advanced gastric cancer (AGC) of stages I to III. Note that the proportion of intestinal type AGC did not decline during the time period (the final time period was 7 years only).

Figure 2 Incidence of gastric cancer treated in Kitasato University Hospital, according to the population of Sagamihara city. A: Incidence is shown between 1972 and 2006, because full annual data for 1971 and 2007 was not available. The incidence of gastric cancer requiring surgery did not decline; B: Incidence of gastric cardia cancer has been increasing until recently. Incidence is per 100 000 population.

Figure 3 Proportion of early gastric cancer and advanced gastric cancer. Early gastric cancer (EGC) was further subdivided into mucosal EGC (Early-mucosal ) and submucosal EGC (Early-submucosa), while advanced gastric cancer was subdivided into stage I-III and stage IV. Note that the proportion of EGC increased over time.

Figure 4 Trend in the number of patients according to the 4 gastric cancer categories in Kitasato University Hospital. The initial year of the critical events in endoscopic resection in Japan is designated by arrows. EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; EGC (Early-mucosal ).

Figure 5 Incidence of advanced gastric cancer treated in Kitasato University Hospital per 100 000 population of Sagamihara city. A: Incidence of advanced gastric cancer (AGC) stage I to III the observed 35 years between 1972 (corresponding to 1) and 2006 (corresponding to 35). Note that the incidence of AGC stage I to III declined during the time period; B: Incidence of AGC stage IV during the same 35 years.

Figure 6 Incidence of early gastric cancer treated in Kitasato University Hospital per 100 000 population in Sagamihara city. A: Incidence of early gastric cancer (EGC) in the 35 years between 1972 and 2006. Note that the incidence of EGC increased during the time period; B: Incidence of EGC-M and EGC-SM during the observed 35 years. The initial year of the critical events in endoscopic resection in Japan is designated by arrows. EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; EGC-M: Early-Mucosa; EGC-SM: Early-Submucosa.

Figure 7 Clinical outcome of gastric cancer requiring surgery in the Kitasato University Hospital. A: Overall survival (OS) of gastric cancer requiring surgery shown according to time period (1971-1980, 1981-1990, 1991-2000). Five-year OS was 57.2%, 67.2%, and 77.4% according to time period, and has remarkably improved; B: Mortality of gastric cancer requiring surgery shown according to time period (1971-1980, 1981-1990, 1991-2000), which is consistent with (A).