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Review
. 2025 Jul;30(7):1268-1275.
doi: 10.1007/s10147-025-02792-4. Epub 2025 May 29.

Multidisciplinary treatment for advanced gastric cancer

Shingo Kanaji  1 , Naoki Urakawa  2 , Hitoshi Harada  2 , Taro Ikeda  2 , Yasufumi Koterazawa  2 , Tomoaki Aoki  2 , Ryuichiro Sawada  2 , Yasunori Otowa  2 , Hironobu Goto  2 , Hiroshi Hasegawa  2 , Kimihiro Yamashita  2 , Takeru Matsuda  2 , Yoshihiro Kakeji  2
Affiliations
Review

Multidisciplinary treatment for advanced gastric cancer

Shingo Kanaji et al. Int J Clin Oncol. 2025 Jul.

Abstract

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.

Keywords: Adjuvant therapy; Advanced gastric cancer; Perioperative chemotherapy.

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Conflict of interest statement

Declarations. Conflict of interest: We certify that this article presents no actual or potential conflict of interest. All authors declare no conflict of interest.

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