(Neo)adjuvant strategies of advanced gastric carcinoma: time for a change?
Markus Moehler1, Carl C Schimanski, Ines Gockel
1First Department of Internal Medicine, Johannes Gutenberg University of Mainz, Mainz, Germany. moehler@mail.uni-mainz.de
Abstract:
Despite surgical R0 resections, patients with gastric cancer stage UICC II-III have a high risk of recurrence and metachronic metastases. Preliminary evidence exists that adjuvant chemotherapy or neoadjuvant chemo(radio)therapy protocols may improve the prognosis of these patients undergoing surgery of gastric cancer with curative intention. As for palliative regimens, 5-fluorouracil and cisplatin are integral components of such (neo)adjuvant strategies. Upcoming cytostatic agents, i.e. irinotecan, docetaxel, oxaliplatin, and oral fluoropyridines are currently under investigation in new multimodality treatment regimens and may further increase R0 resection rates and may prolong disease-free and overall survival in the treatment of advanced localized gastric cancer.
