Adjuvant studies in gastric cancer in the United States

Early optimism for the chemotherapeutic augmentation of standard surgical treatment of gastric cancer has thus far generally not come to pass. First attempts to destroy circulating cancer cells in small metastatic foci by giving drugs at the completion of operation and in the immediate postoperative period were disappointing. Numerous large cooperative groups and individual institutions are now studying drugs and drug combinations in various treatment regimens and have introduced the use of radiotherapy and immunotherapy in an effort to improve long-term survival following surgical resection of gastric cancer. Resurgence of interest in surgical adjuvant studies, and especially recent encouraging results from drug and immunotherapy, generates optimism that the theoretical potential of this approach to cancer control may soon be realized.