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. 2023 Dec 31;44(1):127–172. doi: 10.1002/cac2.12516
Stratification* Grade I recommendations Grade II recommendations Grade III recommendations
Stage II:

  • pT1N2‐3aM0

  • pT2N1‐2M0

  • pT3N0‐1M0

  • pT4aN0M0

with R0 resection and D2 dissection		 Adjuvant chemotherapy:

  • XELOX (Evidence 1A)

  • S‐1 alone (Evidence 1A)

 Adjuvant chemotherapy:

  • XP (Evidence 1B)

  • SOX (Evidence 1B)

 Adjuvant chemotherapy: FOLFOX (Evidence 2B)
Stage III:

  • pT1N3bM0

  • pT2N3M0

  • pT3N2‐3M0

  • pT4aN1‐3M0

  • pT4bN0‐3M0

with R0 resection and D2 dissection		 Adjuvant chemotherapy:

  • XELOX (Evidence 1A)

  • SOX (Evidence 1A)

 Adjuvant chemotherapy: S‐1 × 1‐DS × 7‐S1 for up to 1 year*** (Evidence 1A) Adjuvant chemotherapy: FOLFOX (Evidence 2B)

  • pT2‐4NanyM0 with R0 resection but did not reach D2 dissection

 Adjuvant chemoradiotherapy: DT 45‐50.4 Gy (concurrent fluoropyrimidine) (Evidence 1A) MDT discussion for optimal treatment regimen ‐
pT2‐4NanyM0 and R1/R2 resection Adjuvant chemoradiotherapy**: DT 45‐50.4 Gy (concurrent fluoropyrimidine) (Evidence 2A) MDT discussion for optimal treatment regimen ‐

Abbreviations: pTNM, pathological tumor‐node‐metastasis; XELOX, capecitabine (Xeloda) and oxaliplatin (Eloxatin); SOX, S‐1 and oxaliplatin; XP, capecitabine (Xeloda) and cisplatin; FOLFOX, folinic acid (leucovorin), 5‐fluorouracil (5‐FU), and oxaliplatin; DS, S‐1 plus docetaxel MDT, Multidisciplinary Team; DT, radiation dose of tumor; AJCC/UICC, American Joint Cancer Committee/Union Internationale Contre le Cancer.

*

According to the 8th AJCC/UICC pathological staging system (pTNM) for gastric cancer;

**

For cases with positive margin or residual tumor, an additional dose can be given according to the specific clinical condition;

***

For patients with poor postoperative physical fitness, consider using S1 × 1‐DS1 × 7‐S1 for up to 1 year