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National Cancer Center Hospital

Conditions Treated
Early-Stage Gastrointestinal Cancer (Esophageal, Stomach, Colon, and Rectal Cancer), Pharyngeal Cancer.

Treatment Methods (Endoscopic Treatment of Early-Stage Gastrointestinal Cancer)

In Japan, the level of endoscopic surgery to remove gastrointestinal cancer ranks it among the most advanced in the world.

In particular, endoscopic submucosal dissection (ESD), a treatment method for excising even large tumors en bloc with an insulation-tipped (IT) knife as long as the tumor has not spread beyond the mucosa, was developed in this hospital and is now used nationwide. Our hospital therefore boasts the highest-level skills and widest experience in ESD found anywhere in the world, and is a magnet for patients with conditions too complex to treat elsewhere, such as large tumors up to 10 cm in diameter, ulcerative scarring (recurrent lesions after treatment), and tumors in sites where endoscopic operation is difficult. Compared with esophageal or gastric ESD, ESD is particularly difficult to use in the colon owing to its thin walls and narrow lumen, but we have treated numerous such cases in our hospital. In all cases, this operation consists only of local resection, and cannot be combined with other procedures such as lymph node dissection, so it is only indicated for early-stage gastrointestinal cancer without lymph node metastasis that has not spread beyond the shallow layers of the mucosa or submucosa. Recent advances have enabled the discovery of early-stage pharyngeal cancer during esophageal cancer treatment, and this can also be treated with ESD.

The effectiveness of endoscopic surgery depends not only on the skills of the operator, but also on the accuracy of diagnosis. Our hospital utilizes techniques such as chromoendoscopy and magnified endoscopy to determine the type of tumor on the basis of factors such as its size and depth and to select the appropriate treatment method, achieving high rates of treatment success. Our staff have been collaborating with manufacturers on the development of a range of endoscopes and IT knives for use in ESD and other forms of endoscopic surgery, and our use of these safer devices is also contributing to our excellent results.

Features of Our Hospital

The National Cancer Center was established 50 years ago with the mission of developing and evaluating the latest diagnostic and treatment methods in the field of cancer, and of promoting the adoption in Japan of those methods that prove useful. It thus stands at the center of a network of Japanese hospitals specializing in various different forms of cancer, in which it also plays a key role. Its dual nature as a research institute and hospital means it is engaged in basic and clinical research studies that can genuinely play a role in treatment, on the basis of collaboration between these two functions.

The National Cancer Center Hospital embodies the functions of a hospital that plays a central role, and is capable of providing treatment that ranks among the best in the world. Endoscopic testing and treatment is one of the fields in which Japan leads the world, and our hospital is a magnet for patients with complicated conditions from many different countries. Our hospital is capable of providing the optimum treatment for individual cancer patients, including surgery and drug therapy. It also offers high-level treatment with interventional radiology (IVR), which is currently attracting attention as a minimally invasive method of treatment using a catheter under imaging guidance.

Results of Gastrointestinal Endoscopic Treatment (Numbers of Patients)

  FY2007 FY2008 FY2009 FY2010 FY2011
Upper Gastrointestinal Endoscopy
Examinations (Esophagus/Stomach/
10,910 10,909 10,174 10,644 10,810
Lower Gastrointestinal Endoscopy
Examinations (Rectum/Colon)
3,569 3,161 2,670 2,756 2,924
Endoscopic Ultrasound Examinations 373 375 402 395 372
EUS/FNA (Endoscopic Ultrasound
Biopsy Procedure)
      48 59
Total Endoscopic Treatment Procedures
for Gastrointestinal Cancer
1,854 1,848 1,849 1,756 1,984
Endoscopic Treatment
for Gastric Cancer (EMR/ESD)
24/410 19/397 36/375 23/334 23/343
Endoscopic Treatment
for Esophageal Cancer (EMR/ESD)
89/25 84/25 95/43 102/45 132/61
Endoscopic Treatment
for Colorectal Tumors (EMR/ESD)
1,212/97 1,216/97 1,177/123 1,132/120 1,210/125

A Message to International Patients from Our Hospital

Dr. Yutaka Saito
Dr. Yutaka Saito
Chief of Gastrointestinal Endoscopy Division

Dr. Yasuaki Arai
Dr. Yasuaki Arai
Hospital Director

Because endoscopic treatment is minimally invasive, if you have been fortunate enough to discover gastrointestinal cancer at an early stage, we hope you will actively consider undergoing endoscopic surgery. At our hospital, you can undergo this procedure with peace of mind due to its extremely low risk of complications. Even if you have been told by other hospitals that your tumor is difficult to treat with endoscopic surgery because of its size or location, please consult with us. We have an excellent international network, and may be able to collaborate with a hospital in your home country before and after treatment. Our hospital not only accepts over 100 specialist doctors from Japan and overseas each year to observe our treatments, with the aim of promoting the adoption of world-leading endoscopic diagnostic and treatment methods developed in Japan, but also treats numerous patients referred to us by top doctors from other countries.

Overview of the Treatment Schedule (Model Case: ESD for Colorectal Cancer)

Information from an endoscopic examination carried out in your home country is required to assess whether you can be accepted for treatment, but if it is also for the purpose of considering whether surgery is indicated, an examination can be performed a week before the scheduled date of surgery. At present, around 1–2 months is required from the time an appointment is made until surgery. This wait may be reduced in urgent cases.

Overview of the Treatment Schedule


External View of Our Hospital Endoscopic Treatment Endoscopic Submucosal Dissection (ESD) under Anesthesia for Intractable Early-Stage Cancer Every year an increasing number of patients are referred to us as cases that are too difficult to treat by university and general hospitals. We are fully equipped with all the endoscopic skills and anesthetic management systems needed to treat such patients.
External View of Our Hospital Endoscopic Treatment
Many doctors visit from Japan and overseas to observe our procedures.
Endoscopic Submucosal Dissection (ESD) under Anesthesia for Intractable Early-Stage Cancer Every year an increasing number of patients are referred to us as cases that are too difficult to treat by university and general hospitals. We are fully equipped with all the endoscopic skills and anesthetic management systems needed to treat such patients.
Established 1964
Clinical Departments
Neurosurgery and Neuro-Oncology, Ophthalmic Oncology, Head and Neck Oncology, Plastic and Reconstructive Surgery, Breast Surgery, Breast and Medical Oncology, Thoracic Surgery, Thoracic Oncology, Esophageal Surgery, Gastric Surgery, Colorectal Surgery, Gastrointestinal Medical Oncology, Endoscopy (Gastrointestinal Endoscopy, Respiratory Endoscopy), Hepatobiliary and Pancreatic Surgery, Hepatobiliary and Pancreatic Oncology, Urology, Gynecology, Orthopedic Surgery/Rehabilitation, Dermatology Oncology, Hematology, Hematopoietic Stem Cell Transplantation, Transfusion Therapy, Pediatric Oncology, Internal Medicine/Dental Division/Emergency Oncology (Internal Medicine/Dental Division/Emergency Oncology), Anesthesiology, Intensive Care Unit (Anesthesiology, Intensive Care Unit), Palliative Care, Psycho-Oncology, Diagnostic Radiology, Radiation Oncology, Pathology/ Clinical Laboratories (Pathology, Clinical Laboratories)


Payment Methods
Cash, Credit Card (VISA, MasterCard), Debit Card
5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045
5–15 minutes on foot
from Tokyo Metro Ginza Station
30 minutes
from Tokyo International Airport (Haneda Airport) by car