Comparing upfront surgery to chemotherapy followed by surgery for advanced gastric cancer

Upfront Surgery Versus NeoAdjuvant Chemotherapy Followed by Surgery for Resectable Advanced Gastric Cancer (SNAC Study): An Observational Retrospective Multicenter Study With Matched Treatment Comparison

San Luigi Gonzaga Hospital · NCT06472063

This study is trying to see if having surgery right away is just as good as getting chemotherapy first before surgery for people with advanced stomach cancer.

Quick facts

Study typeObservational
Enrollment684 (estimated)
Ages18 Years and up
SexAll
SponsorSan Luigi Gonzaga Hospital (other)
Locations1 site (Orbassano, Piedmont)
Trial IDNCT06472063 on ClinicalTrials.gov

What this trial studies

This observational study aims to evaluate the non-inferiority of upfront surgery with optimal D2 lymphadenectomy compared to neoadjuvant chemotherapy followed by surgery in patients with resectable advanced gastric cancer. It will include patients with locally advanced adenocarcinoma of the stomach who underwent either treatment approach between January 2012 and December 2019. The study will analyze outcomes based on a matched comparison of the two therapeutic strategies, focusing on survival and efficacy. Data will be collected retrospectively from multiple centers across the nation.

Who should consider this trial

Good fit: Ideal candidates are adults over 18 with locally advanced, histologically proven gastric adenocarcinoma that is resectable and without distant metastases.

Not a fit: Patients with distant metastases, infiltration of adjacent structures, or those with non-resectable gastric cancer will not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide insights into the most effective treatment approach for advanced gastric cancer, potentially improving patient outcomes.

How similar studies have performed: Previous studies have explored similar treatment comparisons, but this specific approach focusing on upfront surgery versus neoadjuvant chemotherapy is less common and may provide novel insights.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* 3.1.1. Locally advanced (T\>2 any N or N+ any T) histologically proven adenocarcinoma of the stomach without distant metastases (M0) and without infiltration of adjacent structures and organs.

3.1.2. D2 lymphadenectomy (based on Japanese gastric cancer guideline) 3.1.3. Age \> 18 years 3.1.4. surgical resectability 3.1.5. follow-up time of at least 36 months.

Exclusion Criteria:

3.2.1. distant metastases (cM+) or infiltration of adjacent structures or organs (cT4b) and all primarily not resectable stages 3.2.2. Other types of lymphadenectomy lower than D2 3.2.3. Siewert type I and II Cardia cancers 3.2.2. Relapsed gastric cancers 3.2.3. malignant secondary disease, dated back \< 5 years (exception: In-situ-carcinoma of the cervix uteri, adequately treated skin basal cell carcinoma)

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Where this trial is running

Orbassano, Piedmont

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.

View on ClinicalTrials.gov →

Conditions: Gastric Cancer, upfront surgery, perioperative treatment, D2 lymphadenectomy

Last reviewed 2026-05-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.