Would you consider perioperative chemotherapy in an anastomotic recurrence of gastric cancer after partial gastrectomy who did not receive prior chemotherapy or radiation?

My practice is to treat this exactly like de novo locally advanced disease. This means that the patient needs to be carefully (re-)staged, including with PET/CT scan, possibly an EUS, and most importantly, a diagnostic laparoscopy. Recurrence at the anastomosis can certainly also be associated with recurrence anywhere else.

Assuming there's no evidence of other sites of disease, I would almost certainly consider some form of preoperative therapy. While this would likely be chemotherapy, it is i...

What my dear friend Dr. @Dr. First Last writes is, of course, entirely correct. I did say in my response that a discussion of the peri-operative vs. TNT (an acronym we really need to handle with care!) approach is beyond the scope of the original question.

However, to be provocative, I would argue that this situation is not the same as a patient with a de novo diagnosis of a similarly staged gastric cancer. It's not an unreasonable hypothesis that such a patient is at higher risk of further syst...