Chemotherapy or surgery first? What is the contemporary management for patients with locally advanced, resectable gastric cancer, and what does the data show? In this episode from the Surgical Oncology team at Behind the Knife, join the discussion on perioperative treatment of locally advanced gastric cancer and future advances that will benefit surgical patients.  Learning Objectives:  In this episode, we review perioperative chemotherapy regimens for locally advanced, resectable Gastric cancer, standard of care, and the future role for immunotherapy.  Hosts:  Adam Yopp, MD, FACS (@AdamYopp) is an Assistant Professor of Surgery at the UT Southwestern Medical Center and is Chief of the Division of Surgical Oncology. He also serves as Surgical Director of the Liver Tumor Program. Caitlin Hester, MD (@CaitlinAHester) is a 2nd Year Complex General Surgical Oncology Fellow at the MD Anderson Cancer Center. Gilbert Murimwa, MD (@GilbertZMurimwa) is a PGY-3 General Surgery Resident at the UT Southwestern Medical Center and a research fellow in the Hamon Center for Therapeutic Oncology Research. Papers Referenced in this Episode: Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial Al Batran et al https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32557-1/fulltext Efficacy and Safety of Pembrolizumab or Pembrolizumab Plus Chemotherapy vs Chemotherapy Alone for Patients With First-line, Advanced Gastric Cancer. The KEYNOTE-062 Phase 3 Randomized Clinical Trial Shitara et al https://jamanetwork.com/journals/jamaoncology/fullarticle/2769922 First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial Janjigian et al https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00797-2/fulltext Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.