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The following treatments show promise but are as yet to be established as standard. They should be prospectively evaluated in appropriate clinical research settings. Patient consent for investigational treatments should be sought and the rationale behind them given (Refer to the Sect. 6 ‘‘Commentary on investigational treatments’’ for details). The following constitute investigational treatments: – Endoscopic submucosal dissection under expanded criteria – Laparoscopic gastrectomy – Local tumor resection – Neoadjuvant chemotherapy – Adjuvant chemotherapy using agents other than S-1 – Neoadjuvant chemoradiotherapy – Adjuvant chemoradiotherapy – Debulking surgery.

Japanese gastric cancer treatment guidelines 2010 (ver. 3)