Adjuvant treatment in gastric cancer. Possibilities to take or to leave it.

The primary mode of management of gastric carcinoma is surgical resection with 5-year survival rate following curative resection of about 30 to 40%. This article reviews the results of randomized clinical trials including adjuvant chemotherapy, radiation treatment and chemoimmunotherapy after curative surgical resection. Randomized trials done to date largely do not support the use of adjuvant chemotherapy in resected gastric cancer. Mitomycin C or FAM association have demonstrated the best efficiency with increase of median survival in treated patients. Mitomycin C demonstrated a significant advantage by reduction of the incidence of hematogenous metastases. Encouraging perspectives come from the association between chemotherapy and biochemical modulators.