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Perioperative chemotherapy
What is the impact of preoperative chemotherapy alone?
Should perioperative chemotherapy be considerd a standard?
What could be the reasons of the undertreatment of gastric
cancer patients despite available high quality evidence?
Has pre-operative treatment a negative impact on posto-operative
outcomes?
Modest
YES!
Lack of multidisciplinary expertise
No
What are potential prognostic markers?
How can we treat non-responding patients?
More is better?
Adjuvant chemotherapy
More is better?
Is it better late than ever?
Lymph node status; TRG
Clinical trials
Probably YES (FLOT4)
May be - Selection of patients is crucial
Perioperative or adjuvant chemotherapy
What is better?
Yes
NAC alone is not enough and AC
alone is not good enough to definitely
improve the OS (after D2 dissection?)
AC is inferior to PC
03/27/2017