Several factors influence the outcome of gastric cancer patients with invasive growth beyond the submucosa, which includes lymphatic and concomitant occult, intraperitoneal tumor cell spread. Organ metastasis or tumor dissemination outside the abdominal cavity is a late finding in gastric cancer compared to other tumor entities. Therapy of gastric cancer thus has to address this fact not only by the complete removal of the primary lesion (R0 resection), but at the same time by the adequate treatment of the routes of tumor cell dissemination. The dissection of the gastric lymph node basins at the time of primary tumor resection constitutes the surgical, and probably most important, part of this treatment. However, invisible tumor spread outside the resectable plane, whether it be peritoneal or within the abdominal organs and tissue, needs additional consideration. Before evaluating additional modalities to tackle this disease-inherent problem, the importance of the experience of the treating surgeon should be stressed. Surgical quality seems to be the most important factor influencing longterm patient survival and sets the benchmark against which all additional (neo) adjuvant treatments must be compared. Historically, postoperative application of chemotherapy has been used first to address the poor outcome of gastric cancer patients (i.e., adjuvant chemotherapy if given after an R0 resection). This approach aims to eliminate any minimal residual tumor, which, at the time of initial treatment, is not detectable by diagnostic means. After two decades of clinical trials and two meta-analyses with inconsistent results, the concept of the preoperative application of chemotherapy was introduced (neoadjuvant chemotherapy). In contrast to adjuvant treatment, neoadjuvant chemotherapy aims primarily at downsizing the primary lesion in order to increase the chance of a complete tumor resection. In the initial trial to test this hypothesis, polychemotherapy–based on cisplatinum–was used, comparable to those known from many previous adjuvant trials. In addition to cytostatic medication, radio-chemotherapy has been evaluated, to improve the local tumor control and thus prolong survival. Three European studies (MAGIC, ACCORD, EORTC 40954), one American trial (SWOG INT 0116), and one Japanese trial (ACTS GC) have addressed these options in the past decade, all with the highest level of methodological evidence. None of the regimens used targeted the intraperitoneal cavity, however, a clinical fact of great importance, which has now been addressed by the Japan Clinical Oncology Group trial (JCOG) 9206-2 reported in this issue of Gastric Cancer. The neoadjuvant application of chemotherapy in all the above-mentioned trials improved the resectability of the primary lesion compared to the surgery-alone arm. Also, all the above-mentioned trials, with the exception of the EORTC 40954 study, showed a statistically significant improvement in survival in the multimodality-treatment arm. In addition, in the United States, radiotherapy, and in Japan, adjuvant chemotherapy, did result in a better outcome if compared to surgery alone. With this short overview in mind, how should we interpret the final results of the JCOG trial 9206-2? This editorial refers to the article doi:10.1007/s10120-011-0027-3.