[The treatment of patients with gastric carcinoma based on the results of Dutch studies].

--The extent of lymph-node dissection in gastrectomy for gastric carcinoma and the use of adjuvant or neo-adjuvant chemotherapy is a matter still under discussion. Only radical resection can offer a cure. --Non-randomised studies show that extended lymph-node dissections are more advantageous than less extended dissections. None of the randomised trials confirms this. The associated statistically significant higher morbidity and mortality offsets its long-term advantageous effect on survival. --If procedures that increase morbidity and mortality such as pancreatectomy and splenectomy can be avoided, then extended lymph-node dissections are more advantageous. --In cases of inadequate dissection (i.e. less than 15 lymph nodes removed) adjuvant radiochemotherapy confers an advantage. If adequate dissection is carried out, this advantage is not present. --To date there is no indication for adjuvant or neo-adjuvant chemotherapy. --To improve the results of treatment for gastric carcinoma in Western countries and to simplify trial participation, treatment for patients with gastric carcinoma should be centralised.