 1. TNM stage of T2-T4 or positive regional lymph nodes, according to the American Joint Committee on Cancer AJCC 7.0 staging system, verified by enhanced abdominal computed tomography CT andor endoscopic ultrasound EUS, positron emission tomography PETCT scan, with no evidence of distant metastases; 2 ECOG performance status score 2 without serious heart, lung, liver, kidney, or hematological dysfunctions; 3age 18 years old; 4 no previous chemotherapy, radiotherapy, or surgical treatment for gastric cancer; 5 gastrectomy was performed after preoperative chemotherapy if imaging studies did not confirm disease progression according to the Response Evaluation Criteria in Solid Tumors RECIST ; and 6 signed the informed consent form. 