J.Jpn. Surg. Soc.. 126(3): 247-253, 2025

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Feature topic

THE ROLE OF SURGEONS AND TASK SHIFTING IN ADVANCED GASTRIC CANCER CHEMOTHERAPY

　In the treatment of advanced gastric cancer, the development of molecular-targeted therapies and immune checkpoint inhibitors has greatly expanded the range of treatment options available, in addition to the conventional cytotoxic anticancer drugs. With the progress of biomarker analysis, personalized treatment is becoming a reality. Until now, chemotherapy for advanced gastric cancer has been mainly administered by surgeons, but the importance of task shifting is increasing, as specialist knowledge is required to manage the side effects of new drugs and understand drug interactions. Chemotherapy management by medical oncologists enables more appropriate, more effective treatment and allows surgeons to focus on surgery and perioperative management. We can also expect to see a reduction in workload and overtime, as well as an improvement in the quality of medical care, with a view to reforming the way we work. However, even with task shifting, the role of surgeons is still important, and their expertise is essential in determining the indications for surgery and deciding on its timing. While surgeons focus on improving the accuracy of minimally invasive surgery using endoscopes and robotics, they also need to keep a close eye on the latest developments in chemotherapy.

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