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Background: The management of gastric adenocarcinoma is essentially based on surgery followed by adjuvant treatment. Adjuvant chemotherapy (CT) as well as chemoradiotherapy (CTRT) have proven their effectiveness in survival outcomes compared to surgery alone. However, there is little data comparing the two adjuvant approaches. This study aimed to compare the prognosis and survival outcomes of patients with gastric adenocarcinoma operated and treated by adjuvant radio-chemotherapy or chemotherapy Materials and methods: We retrospectively evaluated 80 patients with locally advanced gastric cancer (LGC) who received adjuvant treatment. We compared survival outcomes and patterns of recurrence of 53 patients treated by CTRT and those of 27 patients treated by CT. Results: After a median follow-up of 38.48 months, CTRT resulted in a significant improvement of the 5-year PFS (60.9% vs. 36%, p = 0.03) and the 5-year OS (55.9% vs. 33%, p = 0.015) compared to adjuvant CT. The 5-year OS was significantly increased by adjuvant CTRT (p = 0.046) in patients with lymph node metastasis, and particularly those with advanced pN stage (p = 0.0078) and high lymph node ratio (LNR) exceeding 25% (p = 0.012). Also, there was a significant improvement of the PFS of patients classified pN2–N3 (p = 0.022) with a high LNR (p = 0.018). CTRT was also associated with improved OS and PFS in patients with lymphovascular and perineural invasion (LVI and PNI) compared to chemotherapy. Conclusion: There is a particular survival benefit of adding radiotherapy to chemotherapy in patients with selected criteria such as lymph node involvement, high LNR LVI, and PNI.

Cutaneous leiomyosarcoma is a rare soft tissue sarcoma. We present a case of a 50-year-old man, with a rare location in the flank. Clinical presentation showed an ulcerative lesion. Imaging features were evocative of malignancy. Surgical excision was performed, involving oblique muscles. The diagnosis of low-grade leiomyosarcoma with free margins was made. No adjuvant therapy was indicated. Clinical and radiological follow-up of the patient during two years did not reveal recurrences. Cutaneous leiomyosarcoma of the flank is extremely rare and takes part in a group of infrequent and unknown tumors. Clinical presentation is unspecific and histological evidence is mandatory for diagnosis. Tumor extension in depth constitutes the major determinant factor for therapeutic management and prognosis. Wide surgical resection is crucial to minimize recurrence risk especially when poor prognostic factors take place.