Summary

Gastric adenocarcinomas, even in the absence of distant metastases, have a poor prognosis which is particularly dis-mal when tumors are located in the cardia, in the event of locoregional lymph node involvement and/or bulky tumors. Postoperative adjuvant chemotherapy has never clearly demonstrated its efficacy on survival. Besides ongoing trials using new and more active regimens, preoperative chemo-therapy has been used for unresectable cancer due to loco-regional extension and when locally advanced cancer is po-tentially resectable but with poor prognosis such as bulki-ness, when tumors are located in the cardia and when there is tumor in the coeliac area at CAT-scan with suspected meta-static lymph nodes. In case of unresectable tumor at initial surgery five publi-cations have reported the ability of chemotherapy to reduc