Validity of the MAGIC study: sufficient for recommendations?

According to the recommendations of the German S3 guideline, perioperative chemotherapy is an integral part of the treatment concept for advanced gastric cancer. The leading trial which examined the effects of perioperative chemotherapy is the MAGIC study. An examination of the validity of this study with a standardized method revealed shortcomings in the six areas: design, protocol, selection of patients, randomization / homogeneity of patient groups, quality of the surgical care and the statistical evaluation. These shortcomings and their influence on the study results are described in this paper to reveal the importance of these effects for discussion in guidelines committees.