Sato Y, Mizusawa J, Katayama H, et al. - Given that the diagnostic criteria of locally advanced gastric cancer (LAGC) patients with cT3–4/N1–3 to minimize contamination of pathological stage I as a candidate for neoadjuvant chemotherapy was inquired in JCOG1302A, and 77.2% of cT3–4 tumors diagnosed by a combination of endoscopy and computed tomography (CT) were shown to be pT3–4 in JCOG1302A, so, researchers utilized JCOG1302A study data for 1,232 patients, to determine if endoscopic ultrasonography (EUS), thin-slice CT, and foaming agent (FA) in CT add to accurate diagnosis of AGC invasion depth. For conventional endoscopy (CE) alone/CE with EUS, the positive predictive value, negative predictive value, and kappa index were identified to be 79.2%/73.7%, 59.2%/58.8%, and 0.38/0.39, these values were 77.8%/75.5%, 62.9%/71.2%, and 0.38/0.39 for 5-mm CT/1-mm CT, and were 78.6%/75.1%, 60.9%/69.7%, and 0.38/0.40 for CT without FA/CT with FA. Overall, findings revealed no remarkable differences in any comparison. Based on the findings, it was inferred that improved diagnostic accuracy of invasion depth in resectable LAGC may not be achieved through additional diagnostic procedures/modalities, like EUS, 1-mm slice CT, or FA in CT.