• 18 years old ≤ 75 years old male or female;

• The primary gastric lesion was diagnosed as gastric adenocarcinoma (papillary adenocarcinoma, tubular adenocarcinoma, mucinous adenocarcinoma, Signet ring cell carcinoma, poorly differentiated adenocarcinoma) by endoscopic biopsy histopathology;

• Before neoadjuvant treatment, the preoperative clinical staging was confirmed to be II and III (cT2N+M0 or cT3-4a/N+M0) through gastroscopy/ultrasound gastroscopy, enhanced CT/MR, or diagnostic laparoscopic exploration (based on AJCC-8th TNM tumor staging);

• 2-4 cycles of neoadjuvant therapy (chemotherapy+/- targeted/immunotherapy, simple chemotherapy);

• After new adjuvant treatment, radical Gastrectomy is feasible after MDT discussion;

• Preoperative ECOG physical condition score of 0/1 or Karst score ≥ 70%;

• Preoperative ASA score I-III;

• The expected survival period exceeds 6 months;

• Willing and able to comply with the research protocol;

⁃ Sign a written informed consent form before enrollment and be fully aware of the right to withdraw from this study at any time.