[Contribution and limitations of peroperative radiotherapy combined with excision-curettage in the treatment of gastric cancers].
Macro- or microscopic residual tumor after surgery is the dominating prognostic factor in the treatment of gastric cancer. The majority of patients die of local recurrence and peritoneal spread. Therefore, in addition to gastrectomy and extended lymphadectomy (compartments 1 & 2) in some centers a adjuvant intraoperative radiotherapy is performed. Recent results of adjuvant intraoperative radiotherapy for gastric cancer revealed a lower local recurrence but there was no improvement in the survival rate for advanced tumor stages. These results are confirmed by our prospective study including 36 patients till now: in the group of 21 survivors there is no sign of a local recurrence. In 15 patients which died meanwhile there was only one case of local recurrence (median follow-up: 9 months, range 1-30 months). Peritoneal spread and liver metastasis were observed as the most frequent cause of death (tumor stage IIIB and IV only).