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Although the prognosis of stage Ⅳ gastric cancer (GC) has been improving recently with new chemotherapeutic and molecular targeting agents,it is not still satisfactory.With the development and improved response of the chemotherapy regimens, we have demonstrated the concept of conversion therapy or adjuvant surgery for stage Ⅳ gastric cancer and it can be defined as surgical treatment aiming at R0 resection after successful chemotherapy, originally unresectable or marginally resectable tumors, technically and/or oncologically.