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In spite of standardization of surgical procedures in the treatment of gastric carcinomas including increased resection rates as well as decreased postoperative mortality long-term survival rates are poor. An improvement of the prognosis by surgery alone can be expected only by tumor free R0-resection. In locally advanced gastric carcinomas with questionable R0-resection some studies could show promissing results using preoperative chemotherapy. This treatment modality enabled increased R0-resection rates with a positive impact on median survival in relation to surgery alone. Randomized trials have to start in the future to verify or to modify these results incorporating new options of multimodality treatment.
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R Pichlmayr
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