[Significance of neoadjuvant chemotherapy for gastric cancer]

Neoadjuvant chemotherapy for high-risk patients with advanced gastric cancer is important to increase the chance for curative resection and make unresectable gastric cancer tumors resectable by down-staging of the tumor. Tumors with H0, P0, T3, T4, or N3 are the best candidates for this therapy. Randomized controlled phase III studies are needed in conjunction with accurate staging of the disease by laparoscopy. The results of histopathologic evaluation of resected materials following preoperative chemotherapy using oral fluoropyrimidine are thought to be useful as an indicator of chemosensitivity for postoperative adjuvant setting.