Japan is one of the world's most experienced countries in gastric cancer — endoscopic treatments in early stages and D2-dissection surgery are reference fields of Japanese surgery.
Organ-preserving techniques such as endoscopic resection (ESD) are applied in early stages.
In advanced disease, multimodal planning combines immunotherapy and targeted agents.
Personalized vaccine (AFTV) may be evaluated as a supportive protocol in suitable cases.
Stage and spread determine the treatment sequence; the decision belongs to the gastroenterology and oncology board.