Résumé
Despite recent progress in the management of gastroesophageal adenocarcinomas, the mortality rate is high and treatment remains a challenging problem for oncologists. Surgical resection is the only curative treatment and is dependant on pTNM stage. Combined modality treatment approaches including systemic chemotherapy have been evaluated in the hope of preventing recurrences and improving overall survival rates. This article reviews data on neoadjuvant and adjuvant treatment modalities for gastroesophageal adenocarcinomas (GEA). Postoperative chemoradiation is favored in the USA for good performance status patients with resected, high-risk gastric or gastroesophageal junction carcinoma (more stage IA). More recently, results from the UK-MAGIC and FNCLCC-FFCD trials have shown improved survival with perioperative chemotherapy in operable gastric and lower oesophageal cancers, and this has impacted on treatment practice in Europe. New strategies, including induction with chemotherapy followed by preop-CRT, adding targeted therapies to perioperative chemotherapy or using new cytotoxic regimens, are being assessed in order to improve the results of current standard treatment and facilitate the delivery of more tailored therapeutic interventions.