Adjuvant therapy for resected gastric carcinoma.

Despite its continued decline over the past 40 years, gastric carcinoma is a common gastrointestinal cancer and a major health problem around the world. In Asian countries, such as Korea, Japan, Taiwan, and China, it remains one of the leading causes of cancer-related death. Similarly, it is a common malignancy in many South American countries, Eastern European countries, and many countries of the former Soviet Union. In North America, the incidence of gastric carcinoma is low; however, the incidence of proximal gastric carcinoma has risen over the past 15 years. In 2001, approximately 21,700 new cases and 12,800 deaths were estimated in the United States as a result of gastric carcinoma. In the United States, gastric cancer ranks 14th among all cancers in incidence rate and 10th in overall mortality rate. An early detection program has been established in Japan, where nearly 6,000,000 adults are screened annually. This type of mass screening for gastric cancer is not practiced elsewhere, however. Because the risk of relapse remains high for patients after a curative resection, there is a great need for effective adjuvant therapy for patients with gastric carcinoma.