Multidisciplinary treatment for advanced gastric cancer.

Outcomes for advanced gastric cancer are improving with multidisciplinary treatment combining surgical resection and perioperative chemotherapy. In Asia, the standard of care for pathological Stage (pStage) II gastric cancer involves tegafur-gimeracil-oteracil potassium for 1 year postoperatively after gastrectomy with D2 lymph node dissection or capecitabine plus oxaliplatin for 6 months postoperatively. For pStage III gastric cancer, a combination of tegafur, gimeracil, and oteracil potassium combined with docetaxel remains the standard postoperative treatment. However, perioperative chemotherapy combined with surgery is being developed to further improve outcomes, similar to approaches in Europe. In addition, the perioperative use of molecularly targeted agents, such as trastuzumab, and immune checkpoint inhibitors, such as pembrolizumab, is expected to improve outcomes. Furthermore, improved chemotherapy outcomes have increased opportunities for surgical intervention in Stage IV gastric cancer, which was previously not indicated for surgery. In this article, we reviewed multidisciplinary treatments for Stage II-IV gastric cancer, combining surgery and chemotherapy.