From October 2006 to December 2018, patients with clinical stage II-III gastric cancer treated with curative gastrectomy following neoadjuvant therapy (NAT-Surgery) or curative gastrectomy followed by adjuvant chemotherapy (Surgery-ACT) at China National Cancer Center were retrospectively reviewed. Inclusion criteria were as follows: presence of locally advanced (cT2-4a and/or N+) gastric adenocarcinoma according to the TNM stage system (American Joint Committee on Cancer, 8th edition); absence of distant metastases confirmed by clinical examination and imaging techniques; no other primary malignancy in the previous 5 years; an Eastern Cooperative Oncology Group performance status (PS) of 0-1. All study procedures were approved by the Institutional Review Board at the China National Cancer Center.

Pretreatment patient evaluation included clinical examination, blood tests, upper gastrointestinal endoscopy ± endoscopic ultrasound (EUS), enhanced chest-abdominal-pelvic enhanced computed tomography-scan (CT-scan) to determine the extent of the disease.

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