That being said, if the downstaging was obtained in conversion surgery patients with distant nodal metastases, we suppose these patients should all have metastatic nodes with a short-axis diameter >=15 mm at staging CT. Considering that in the conversion surgery group: (i) distant nodal metastases were identified in 12 patients (48.0%), peritoneal/omental metastases in 9 patients (36.0%), liver metastases in 5 patients (20.0%), and ovarian metastases in 3 (12.0%) patients; (ii) downstaging (pathological stage I-III) was noted in 15 (60%) and non-downstaging in 10 (40%) patients; and finally, (iii) tumor response was defined using the Response Evaluation Criteria in Solid Tumors (RECIST), some concerns arise from a radiological point of view. In our case studies of mGC patients, distant node metastases were identified in 32/74 patients, and they were the only metastatic site in 7/74 patients. [Extracted from the article]