[Comparisons of standard treatments for colorectal cancer between Japan and Western Countries].

In order to distinguish the differences in standard treatment for colorectal cancer between Japan and Western countries, we compared several issues in clinical practice guidelines (guidance) of Japan, the United States and the United Kingdom. Endoscopic resection is not common in Western countries, so its feasibility and efficacy should be determined in Japan. Laparoscopic resection, however, is applied to more advanced diseases. Expansion of the indication is now also under consideration in Japan a waiting the results from clinical trials. Although with chmeotherapy for advanced or metastatic diseases, the use of molecular targeting agents is recommended in the United States, it is not in the United Kingdom mainly because it is not cost-effective. The indication of adjuvant chemotherapy is similar in Japan and Western countries. Patients with Stage III disease and high-risk Stage II are good candidates for adjuvant chemotherapy. Enrollment in clinical trial should be considered for remaining Stage II patients. Surgery is considered to be the major treatment modality in Japan for the treatment of liver and lung metastases and advanced rectal cancer. However, neo-adjuvant chemo (-radio) therapy is considered to be the standard treatment in Western countries. Development of a new treatment modality for colorectal cancer has progressed very rapidly, and the standard treatment has changed dramatically. While guidelines should be revised frequently according to new evidence, the standard treatment must be cautiously determined based on cost-effectiveness.