Gastric cancer adjuvant therapy.

From a global perspective, gastric cancer is one of the most common and lethal forms of cancer. The incidence of gastric cancer is very high in East Asia and varies considerably in countries of the Western hemisphere. Even after curative resection, the relapse rates are high in stages II and III. Therefore, adjuvant treatment with chemotherapy has been studied with positive results, especially in East Asian populations. In the Western World, where many locally advanced and borderline resectable gastric cancers are diagnosed, perioperative chemotherapy has become a standard of care. Perioperative chemotherapy increases the chances for curative resection. The additional role of radiation therapy, either in the neoadjuvant or in the adjuvant setting, needs to be defined by studies with a quality assurance for all treatment modalities.