Adjuvant chemotherapy in gastric cancer. The Italian experience and review of the literature.
OBJECTIVE
Surgery is the treatment of choice for locally advanced gastric cancer, but the 5-year survival rate is still disappointing. The aim of the present review is to summarize the results of previously performed randomized trials to evaluate the effects of adjuvant therapy in gastric cancer.


METHODS
We searched the Medline database for the following items: randomized trial, adjuvant therapy for gastric cancer, stomach neoplasms and adjuvant chemotherapy, meta-analysis of adjuvant chemotherapy for gastric cancer. We also searched the bibliographies of all papers, as well as review articles, to identify other studies.


RESULTS
The results of chemotherapy in the adjuvant setting are disappointing and, although some randomized controlled trials have reported positive results, none of them provides strong evidence that adjuvant chemotherapy really works. Therefore, surgery remains the mainstay of therapy of gastric cancer.


CONCLUSIONS
Further studies are warranted to identify more satisfactory strategies as well as to identify patients who are more likely to benefit from an adjuvant treatment.
Berardi
Rossana
R
Medical Oncology Department, University of Ancona, Azienda Ospedaliera Umberto I, Ancona, Italy.
Scartozzi
Mario
M
Galizia
Eva
E
Cascinu
Stefano
S
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D006801:Humans; D007558:Italy; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic; D020360:Neoadjuvant Therapy; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome