103 REVIEW Lib Oncol. 2021;49(2-3):103–107 doi: 10.20471/LO.2021.49.02-03.14 PERIOPERATIVE TREATMENT OF GASTRIC CANCER - SHORT REVIEW JOSIPA FLAM 1,2 , LUKA PERIĆ 1,2 , MIRELA ŠAMBIĆ PENC 1,2 , MAJA KOVAČ BARIĆ 1 , DARKO KOTROMANOVIĆ 1,2 , NORA PUŠELJIĆ 2,3 and IVANA CANJKO¹ 1 Department of Oncology, University Hospital Center Osijek, Osijek, Croatia; 2 Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia; 3 Emergency medicine, University Hospital Center Osijek, Osijek, Croatia Summary Adenocarcinoma of the gastroesophageal junction (GEJ) and gastric cancer have poor outcomes in most patients. Perioperative chemotherapy became a standard of care for resectable adenocarcinoma of the upper GI tract based on the results of the MAGIC trial. The study includes patients with Stage II or III resectable adenocarcinoma of the stomach, GEJ, and lower esophagus. The ACCORD trial essentially supported the results of the MAGIC study. Both studies showed that preoperative chemotherapy could induce downstaging and enhance the possibility of poten- tially curative R0 resection, thus increasing the probability of disease-free survival and overall survival. The NeoFLOT study investigates the application of prolonged neoadjuvant chemotherapy (NACT). This study indi- cates that NACT with six cycles of FLOT is highly efective in resectable gastroesophageal cancer. The CRITICS trial com- pares perioperative chemotherapy with preoperative and postoperative chemoradiotherapy in patients with resectable gas- tric adenocarcinoma. Postoperative chemoradiotherapy did not improve overall survival compared with postoperative chemotherapy in patients with resectable gastric cancer treated with adequate preoperative chemotherapy and surgery. In recent years, guidelines for the treatment of gastric cancer have changed frequently. Because gastric cancer treat- ment is complex and perioperative chemotherapy is present in all treatment guidelines, a multidisciplinary team with expe- rienced physicians is the foundation of efective gastric cancer treatment. KEYWORDS: stomach neoplasms, chemoradiotherapy, neoadjuvant chemotherapy Corresponding author: Josipa Flam, Department of Oncology, University Hospital Center Osijek, J.Hutlera 4, 31000 Osijek and Faculty of Medicine, University of J.J.Strossmayer Osijek, Cara Hadrijana 10E, 31000 Osijek, Croatia. e-mail jfam@mefos.hr INTRODUCTION Adenocarcinoma of the gastroesophageal junction (GEJ) and gastric cancer has poor out- comes in most patients. Gastric cancer has over one million new cases in one year, and because of that, it is globally non- neglectable. With over one million cases annually, it is the ffth most diagnosed neoplasm in the world. Because of its poor overall survival and ex- treme aggressiveness, it is globally ranked fourth for mortality in 2020(1,2). Because of late diagno- sis, the prognosis is very poor, with an average 5-year survival rate of less than 20%. Countries like Japan have set up screening programs that help with early detection. If cancer is detected and treated before invading the muscular layer, the 5-year survival rate is exceptionally high and can reach up to 90%(3). The tumor stage is the most important factor determining the treatment mo- dality, treatment efectiveness, and strategy. Early gastric cancer can undergo radical operation fol- lowed by chemotherapy, and its 5-year survival