Perioperative FLOT vs Adjuvant XELOX for CA Stomach

This study is comparing two chemotherapy strategies for people with locally advanced stomach or gastroesophageal junction (GEJ) cancer. One approach (FLOT) gives chemotherapy before and after surgery; the other (XELOX) gives chemotherapy only after surgery. The goal is to find out which approach works better. **You may be eligible if...** - You are between 18 and 80 years old - You have been diagnosed with locally advanced adenocarcinoma of the stomach or where the esophagus meets the stomach - Your cancer is Stage T3 or higher and/or has spread to nearby lymph nodes, but has not spread to distant organs - Your cancer is considered surgically removable - You have not had prior stomach surgery or chemotherapy - You are in generally good health (ECOG 0–2) **You may NOT be eligible if...** - Your cancer has spread to other organs (distant metastases) - You have an allergy to any of the study drugs - You have serious heart disease (NYHA Class III or IV heart failure) - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.