[Multimodality therapy concepts in stomach carcinoma].
The prognosis of gastric cancer is still poor even after curative R0 resection. Therefore, among various multimodality treatments a lot of phase II/III studies have been carried out evaluating preoperative chemotherapy. Although some positive results have been obtained after this procedure, neoadjuvant chemotherapy is still an experimental approach. In the future the prediction and evaluation of response must be defined more exactly. Using intraoperative radio- or intraperitoneal (hyperthermal) chemotherapy reduction of regional relapse or peritoneal carcinomatosis could be obtained without increased survival in general. According to experience in Japan adjuvant (immuno-)chemotherapy can increase the overall survival rates and even in the Western hemisphere some actual studies with adjuvant chemo- +/- radiotherapy could demonstrate a benefit of survival in patients with lymph node metastases. Nevertheless, multimodality treatment strategies must be investigated in further uniform prospective study protocols.
Meyer
H J
HJ
Klinik für Allgemein- u. Viszeralchirurgie, Städt. Klinikum Solingen, Gotenstrasse 1, 42653 Solingen.
Zachert
H R
HR
Opitz
G J
GJ
Raab
C
C
Wilke
H
H
D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate