[Comments on the seven clinical questions & answers in Japanese gastric treatment guidelines of the 4th edition].

Japanese gastric cancer treatment guidelines of the 4th Edition proposed solutions to 7 clinically contentious questions. However, the solutions to question 1-3 are not complete and may cause ambiguity. In order to avoid the wrong choice of surgical resection, the solutions to question 1-3 should be clearly defined. For question 1-3, we suggest provisos be added such as patients with resectable M1 disease and without any other non-curable factors, after whose status and tumor biological behavior being fully understood and being fully discussed by a multidisciplinary team, can be recommended to receive comprehensive treatment including surgical resection.