Fig. 1.

Flow chart for decision-making regarding adjuvant treatment for resectable gastric cancer. ^aD2 surgery if surgeon’s experience ensures a safe and effective procedure. If a standardized D2 surgery is not feasible, D1 surgery with chemoradiotherapy3 or preoperative chemotherapy2 can be considered. ^bAdjuvant treatment: Cisplatin-based chemotherapy for Western patients, S-1 chemotherapy for East Asian patients. Addition of targeted agents to empirical chemotherapy only in randomized trials. RCTs: randomized controlled trials.