Treatment Strategy for Stage IV Gastric Cancer with Positive Peritoneal Cytology As the Only Non-curable Factor

Inclusion Criteria:

* Pathologically diagnosed gastric adenocarcinoma with endoscopic biopsy;
* Pretreatment clinical stage with computed tomography and/or endoscopic ultrasonography;
* Clinical stage cT2-4 N0-3 M0;
* Standard gastrectomy with D2 lymphadenectomy is needed according to the clinicians' evaluation;
* ECOG performance score ≤2, with tolerance of standard gastrectomy and D2 lymphadenectomy;
* Positive peritoneal cytology;
* Signed informed consent.

Exclusion Criteria:

* Remnant gastric cancer, recurrence gastric cancer or multi-primary cancers;
* Intraoperative identified other unresectable factors including other metastasis except positive peritoneal cytology;
* Postoperative pathologically diagnosed as non adenocarcinoma;
* Pregnant or lactate women;
* Child-bearing period adults who refuse to birth control during the trial;
* Uncontrolled epilepsy, CNS disease or mental disorder that may influence the compliance of the patient;
* Severe/active heart disease, including but not limited to acute coronary syndrome, congestive heart failure with less than NYHA II cardiac function, severe arrhythmia that needs drug control, cardiac infarction within 12 month;
* Organ transplantation patients who needs immune suppression therapy;
* Patients who needs emergency surgery because of bleeding, perforation or obstruction.