Outcome of secondary gastrectomy for stage IV gastroesophageal adenocarcinoma after induction-chemotherapy

Stage IV gastric cancer represents a therapeutic challenge in gastric cancer treatment. Despite initiation of screening programs almost a quarter of the patients still present with metastatic disease. As palliative chemotherapy and best supportive care concepts were standards in the past, new therapeutical concepts are emerging over the recent years. Advancements in surgical therapy for metastatic gastric cancer revealed promising results over the past 5 years. However the only prospective trial on palliative gastrectomy for metastatic disease could not confirm the promising retrospective data. Therefore multimodal treatment concepts incorporating preoperative chemotherapy, hyperthermic intraperitoneal chemotherapy (HIPEC) and intraperitoneal (IP) chemotherapy have led to improved response rates requiring reevaluation of conversion surgery. This review summarizes the most promising results from retrospective studies published in the recent past and presents an outlook of ongoing clinical trials.