This includes Neo-adjuvant (preoperative) Chemo-RT or Adjuvant (postoperative) Chemo-RT. Purpose of adjuvant treatment is to reduce tumour size, prevent local recurrence and inhibit distant metastasis. Very early tumours may go for surgery directly and may not require any additional treatment, but for majority of tumours adjuvant treatment helps in improving survival. For cancer of Esophagus and anorectum treatment is Chemo-RT followed by surgery whereas for cancer stomach it is perioperative chemotherapy.
Hepato-pancreatobiliary and colon cancers in general require post of chemotherapy. Need of adjuvant treatment is decided by stage of disease, clinico-radiological staging for Neoadjuvant treatment and histopathological staging for adjuvant treatment.