Site	Stratification	Grade I recommendations	Grade II recommendations	Grade III recommendations
Peritoneal cytology positive (P0CY1)*	ECOG performance score = 0–1, radical resection of the primary lesion and regional lymph nodes	To be treated as recurrent/metastatic gastric cancer or encourage to participate in clinical trials	Standard D2 gastrectomy followed by postoperative chemotherapyb (Evidence 2B) Conversion chemotherapy combined with radical surgeryc (Evidence 2B)
Retroperitoneal lymph node metastasis (station No. 16a2/b1)	ECOG performance score = 0–1, radical resection of the primary lesion and regional lymph nodes		Conversion chemotherapy combined with radical surgeryd (Evidence 2B)	Radical surgery combined with chemoradiotherapy (Evidence 3)
Single liver metastasis	ECOG performance score = 0–1, radical resection of the primary lesion and regional lymph nodes		Systemic chemotherapy combined with local treatmente (Evidence 2A)	Surgical resection of primary and metastatic tumor combined with systemic chemotherapyf (Evidence 2B)
Ovarian metastasis	ECOG performance score = 0–1, radical resection of the primary lesion and regional lymph nodes			Surgery combined with systemic chemotherapyg (Evidence 2B)

* P0CY1: No peritoneal metastasis, but the peritoneal cytology is positive for carcinoma cells