Gastric cancer: overview of current therapies.

The worldwide results of surgical adjuvant therapy for gastric cancer are reviewed. Studies from Japan suggest that earlier initiation of chemotherapy results in significantly improved survival, even in advanced resectable disease. Sites of cancer recurrence were evaluated. Transperitoneal and lymph node metastases were the major causes of treatment failure. It is suggested that these sites of recurrence be targeted in future surgical adjuvant therapy trials through preoperative, intraoperative, and early postoperative systemic and intraperitoneal therapy to control microscopic residual disease at a time when the tumor burden is the smallest.