[Hypothetical and reliable aspects of pre-, intra- and postoperative adjuvant therapy of stomach carcinoma].

The results of surgical therapy of gastric cancer could not be improved in recent years. Therefore, different perioperative modalities were investigated for this tumor. A series of studies could not show any survival benefit using postoperative adjuvant radio- or chemotherapy after complete resection of the tumor. Data available about preoperative chemotherapy in locally advanced tumor stages may demonstrate an increased R0-resection rate after objective remission resulting in a prolonged survival compared to surgery alone. Furthermore, in others trials intraoperative radiation or intraperitoneal chemotherapy could decrease the incidence of locoregional recurrence or peritoneal carcinomatosis and improve the overall survival rate. These treatment modalities, above all preoperative chemotherapy, must be proven in precisely defined patient populations within prospective trials to achieve clearcut data in the future.