Clinical staging*		Stratification	Grade I recommendations	Grade II recommendations	Grade III recommendations
I	cT1aN0M0	Patients not suitable for EMR/ESDd	D1 gastrectomy (Evidence 1A)	Laparoscopic D1 gastrectomy (distal or total)b (Evidence 1B)
	cT1bN0M0	Patients suitable for surgeryd	D1 gastrectomy (differentiated type, <1.5 cm) or D1+ gastrectomy (other indications) (Evidence 1A)	Laparoscopic D1/D1+ gastrectomy (distal or total)b (Evidence 1B)
	cT2N0M0	Patients suitable for surgeryd	D2 gastrectomy (Evidence 1A)	Laparoscopic D2 gastrectomy (distal)b (Evidence 1A)
II	cT1‐2N1‐3M0 cT3‐4N0M0	Non‐EGJ cancer and patients suitable for surgeryd	D2 gastrectomy (Evidence 1A) + adjuvant chemotherapy (Evidence 1A)	Laparoscopic D2 gastrectomy (distal)b (Evidence 1A) + adjuvant chemotherapye (Evidence 1A)
		EGJ cancer and patients suitable for surgeryd	Neoadjuvant chemotherapy + D2 gastrectomy + adjuvant chemotherapyd (Evidence 1B), Neoadjuvant chemoradiotherapy + D2 gastrectomy + adjuvant chemotherapy (Evidence 1B)	D2 gastrectomy (Evidence 1A) + adjuvant chemotherapy (Evidence 1B)
III	cT3‐4aN1‐3M0	Non‐EGJ cancer and patients suitable for surgerye	D2 gastrectomy (Evidence 1A) + adjuvant chemotherapy (Evidence 1A) Laparoscopic exploratione (Evidence 1B) + Neoadjuvant chemotherapy + D2 gastrectomy + adjuvant chemotherapye (Evidence 1B)	Laparoscopic D2 gastrectomy (distal) (Evidence 1A) + adjuvant chemotherapye (Evidence 1A)
		EGJ cancer and patients suitable for surgerye	Laparoscopic exploratione (Evidence 1B) + Neoadjuvant chemotherapy/ chemoradiotherapy + D2 gastrectomy + adjuvant chemotherapye (Evidence 1B)	D2 gastrectomy (Evidence 1A) + adjuvant chemotherapy (Evidence 1B)
IVA	cT4bN0‐3M0	Cases with no unresectable factors	MDT discussion for the optimal personalized management	Laparoscopic exploratione (Evidence 1B) + neoadjuvant chemoradiotherapy + gastrectomy (combined resection of invading organs) + adjuvant chemoradiotherapy (Evidence 2B)	Encourage participation in clinical trials
Stage I‐IVA		Patients unsuitable for surgery	Refer to section “2.1.2 Comprehensive Treatment for Unresectable Gastric Cancer”

^*The 8^th edition of the AJCC/UICC clinical staging system (cTNM).

^**Unresectable factors are 1) tumors with involvement of the mesenteric root or para‐aortic lymph nodes (highly suspected on imaging or confirmed by biopsy), 2) tumors have invaded or encapsulated important blood vessels (excluding the splenic artery), and 3) distant metastasis or peritoneal seeding (including positive cytological examination of intraperitoneal washings).

Abbreviations: EMR, endoscopic mucosal resection; ESD, endoscopic submucosal dissection; D, type of lymphadenectomy; EGJ, esophagogastric junction;