Gastric cancer

Although gastric cancers are localized and surgically resectable in approximately 50% of patients at the time of diagnosis, regional metastases and direct invasion of surrounding structures frequently preclude cure by surgery alone. With recurrent or metastatic disease, some palliation can be obtained by chemotherapy, surgery, or irradiation, but few patients can actually be cured. This chapter addresses the rationale for adjuvant treatment in resectable disease and discusses results with single or combined modalities in locally advanced disease. The chapter also discusses future possibilities for aggressive combined modality approaches in patients who have undergone resection but are at high risk, who have undergone resection but have residual disease, or who have locally unresectable or recurrent disease