Tackling similarities and differences in global practice guidelines for gastric cancer: a review on the latest Taiwan guidelines with Asia-Pacific, European and US guidelines

Abstract Background Gastric cancer (GC) remains a global health burden. While international guidelines share consensus, variations exist in disputed issues. The 2025 Taiwan Consensus and Management Guidelines for Gastric Cancer had just been released. We compared the key recommendations with established international guidelines. Methods A multidisciplinary taskforce addressed key questions and recommendations using modified Delphi method and evidence-based approaches. The comparative review aimed to elucidate similarities and differences among guidelines from Taiwan, Japan, South Korea, China, Europe, and the US. Results Guidelines converge on absolute endoscopic resection criteria for early GC but differ in extended indications and perioperative approaches for locally advanced disease. Heterogeneity exists in biomarker assessment protocols, cutoff thresholds, and companion diagnostics. For metastatic disease, consensus exists on anti-HER2, anti-VEGF, immunotherapy, and biomarker-driven strategies, though oligo-metastatic definitions and intraperitoneal chemotherapy indications remain controversial. Conclusion Optimal GC management requires integrating global evidence with regional contexts. The comparative review addresses heterogeneity among international guidelines, which helps harmonize management strategies as therapeutic standards evolve.

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Publication Details

Journal
Gastric Cancer
Published
2026-05-18
DOI
https://doi.org/10.1007/s10120-026-01753-8
Primary Topic
Gastric Cancer Management and Outcomes
Type
article
Field-Weighted Citation Impact
0.00
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article

Tackling similarities and differences in global practice guidelines for gastric cancer: a review on the latest Taiwan guidelines with Asia-Pacific, European and US guidelines

Cheng‐Chan Yu, Cheng‐Ming Peng, Tzu‐Chan Hong, Jaw‐Yuan Wang et al.
Gastric Cancer
Gastric Cancer Management and Outcomes
article

Tackling similarities and differences in global practice guidelines for gastric cancer: a review on the latest Taiwan guidelines with Asia-Pacific, European and US guidelines

Cheng‐Chan Yu, Cheng‐Ming Peng, Tzu‐Chan Hong, Jaw‐Yuan Wang, Hui‐Hua Hsiao, Y S Chen, Ming‐Wun Wong, JF Hsu, Chan‐Keng Yang, Chih-Chieh Yen, Li-Tzong Chen, De-Chuan Chan, Kuo-Hsing Chen, Chieh-Chang Chen, Chia-Jui Yen, Wen-Chi Chou, Jiann-Ming Wu, I-Shu Chen, Kun-Ming Rau, Ta-Sen Yeh, I-Chen Wu, Jen-Shi Chen, Wen-Liang Fang, Yan-Shen Shan, Li-Yuan Bai, Nai-Jung Chiang, Ming-Huang Chen, Yao-Yu Hsieh, Yi-Fang Chang, Yueh-Wei Liu
article en

Abstract

Abstract Background Gastric cancer (GC) remains a global health burden. While international guidelines share consensus, variations exist in disputed issues. The 2025 Taiwan Consensus and Management Guidelines for Gastric Cancer had just been released. We compared the key recommendations with established international guidelines. Methods A multidisciplinary taskforce addressed key questions and recommendations using modified Delphi method and evidence-based approaches. The comparative review aimed to elucidate similarities and differences among guidelines from Taiwan, Japan, South Korea, China, Europe, and the US. Results Guidelines converge on absolute endoscopic resection criteria for early GC but differ in extended indications and perioperative approaches for locally advanced disease. Heterogeneity exists in biomarker assessment protocols, cutoff thresholds, and companion diagnostics. For metastatic disease, consensus exists on anti-HER2, anti-VEGF, immunotherapy, and biomarker-driven strategies, though oligo-metastatic definitions and intraperitoneal chemotherapy indications remain controversial. Conclusion Optimal GC management requires integrating global evidence with regional contexts. The comparative review addresses heterogeneity among international guidelines, which helps harmonize management strategies as therapeutic standards evolve.

Gastric Cancer
Tri-Service General Hospital (TW), Kaohsiung Medical University (TW), National Taiwan University (TW), Chang Gung University (TW), China Medical University (TW), Kaohsiung Medical University Chung-Ho Memorial Hospital (TW), Mackay Memorial Hospital (TW), Taipei Veterans General Hospital (TW), E-Da Hospital (TW), Kaohsiung Chang Gung Memorial Hospital (TW), Far Eastern Memorial Hospital (TW), Chung Shan Medical University Hospital (TW), Linkou Chang Gung Memorial Hospital (TW), Hualien Tzu Chi Medical Center (TW), China Medical University Hospital (TW), Taichung Hospital (TW), National Taiwan University Hospital (TW), Kaohsiung Veterans General Hospital (TW), Taipei Medical University-Shuang Ho Hospital (TW), Taichung Armed Forces General Hospital (TW), National Cheng Kung University Hospital (TW)
Partnerships for the goals
Openalex Percentile: Top 7%
Gastric Cancer Management and Outcomes
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