title: Current adjuvant treatment modalities for gastric cancer: From history to the future.
abstract: The discrepancy between the surgical technique and the type of adjuvant chemotherapy used in clinical trials and patient outcomes in terms of overall survival rates has led to the generation of different adjuvant treatment protocols in distinct parts of the world. The adjuvant treatment recommendation is generally chemoradiotherapy in the United States, perioperative chemotherapy in the United Kingdom and parts of Europe, and chemotherapy in Asia. These options mainly rely on the United States Intergroup-0116, United Kingdom British Medical Research Council Adjuvant Gastric Infusional Chemotherapy, and the Asian Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer and Capecitabine and Oxaliplatin Adjuvant Study in Stomach Cancer trials. However, the benefits were evident for only certain patients, which were not very homogeneous regarding the type of surgery, chemotherapy regimens, and stage of disease. Whether the dissimilarities in survival are attributable to surgical technique or intrinsic biological differences is a subject of debate. Regardless of the extent of surgery, multimodal therapy may offer modest survival advantage at least for diseases with lymph node involvement. Moreover, in the era of individualized treatment for most of the other cancer types, identification of special subgroups comprising those who will derive more or no benefit from adjuvant therapy merits further investigation. The aim of this review is to reveal the historical evolution and future reflections of adjuvant treatment modalities for resected gastric cancer patients.
authors.affiliation: Leyla Kilic, Department of Medical Oncology, Acibadem University Hospital, Istanbul 34394, Turkey.
authors.forename: Leyla
authors.initials: L
authors.lastname: Kilic
authors.affiliation: Leyla Kilic, Department of Medical Oncology, Acibadem University Hospital, Istanbul 34394, Turkey.
authors.forename: Cetin
authors.initials: C
authors.lastname: Ordu
authors.affiliation: Leyla Kilic, Department of Medical Oncology, Acibadem University Hospital, Istanbul 34394, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yildiz
authors.affiliation: Leyla Kilic, Department of Medical Oncology, Acibadem University Hospital, Istanbul 34394, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Sen
authors.affiliation: Leyla Kilic, Department of Medical Oncology, Acibadem University Hospital, Istanbul 34394, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Keskin
authors.affiliation: Leyla Kilic, Department of Medical Oncology, Acibadem University Hospital, Istanbul 34394, Turkey.
authors.forename: Rumeysa
authors.initials: R
authors.lastname: Ciftci
authors.affiliation: Leyla Kilic, Department of Medical Oncology, Acibadem University Hospital, Istanbul 34394, Turkey.
authors.forename: Kezban Nur
authors.initials: KN
authors.lastname: Pilanci
keywords: Adjuvant chemoradiotherapy; Biomarker; Gastric cancer; Lymph nodes