Complete Cytoreduction Followed by IP and Systemic Chemotherapies for Gastric Cancer With Peritoneal Carcinomatosis

\[Inclusion criteria\] 1. Age 20 to 75 years old. 2. Blood tests: 1. White blood cells \> 4,000/mm3, neutrophils \> 1,500/mm3, platelets \> 100,000/mm3. 2. Serum creatinine \< 1.5 mg/dl or creatinine clearance \> 60 ml/min. 3. Serum bilirubin \< 2 mg/dl. 3. Eastern Cooperative Oncology Group (ECOG) Performance Status = 0 or 1. 4. Not legal incapacity. 5. Newly diagnosed gastric adenocarcinoma, including Siewert III adenocarcinoma of the cardia, with limited peritoneal carcinomatosis (PCI ≤ 10) or positive peritoneal wash cytology (CY1/P0) . \[Exclusion criteria\] 1. Prior malignancy within 3 years or with detectable signs of recurrence. 2. Newly diagnosed gastric adenocarcinoma having been treated by preoperative systemic or intraperitoneal chemotherapy. 3. Presence of comorbidities, including liver cirrhosis (≥ Child B), decompensated heart failure (New York Heart Association \[NYHA\] Class III or IV congestive heart failure), poorly-controlled chronic obstructive pulmonary disease. 4. ≥ American Society of Anesthesiologists Classification (ASA Class) Class 3. 5. Pregnancy or breastfeeding. 6. Intolerability of chemotherapeutic agents in this study: 1. N-IPEC paclitaxel (all patients). 2. Capecitabine or oxaliplatin (patients who receive CAPOX regimen). 3. Cisplatin or 5-fluorouracil (patients who receive P-HDFL regimen). 7. Distant metastases (e.g. liver, lung, bone) except for the peritoneum, intra-abdominal lymph node, and ovary. 8. Extensive PC (PCI \> 10). 9. Siewert I or II adenocarcinoma of the cardia. 10. Other patients inappropriate for this study in the opinion of the investigators.