Perioperative chemotherapy for gastric cancer

Abstract

Radical surgery is the mainstay for the treatment for advanced gastric cancer. However, the results are still not satisfactory. Various kind of perioperative chemotherapy has been evaluated to improve the therapeutic results. In Japan, adjuvant chemotherapy is regarded as a standard treatment. Japanese gastric cancer treatment guidelines have recommended the adjuvant chemotherapy with S-1 for 1 year in patients with pStage II or III gastric cancer. Meanwhile, the efficacy of S-1 plus docetaxel has been demonstrated in Stage DI gastric cancer, and it is recommended as a standard treatment for Stage I gastric cancer in the guidelines. On the contrary, neoadjuvant chemotherapy (NAC) is regarded as a standard treatment for advanced gastric cancer in the West. The FLOT regimen is recommended for patients with good performance status. As the patient background and operative results are significantly different between the West and the East, extrapolation of the Western evidences seems to be difficult. We have to establish our own evidence of NAC.