Gastric cancer remains a major health problem worldwide and has been considered as a dynamic disease that has potential to spread through various routes, such as hematogenous metastasis, lymphatic metastasis, or peritoneal seeding (1-4). Relatively aggressive behavior of gastric cancer may cause metastasis even in the early stages of the disease, and metastases may affect multiple focuses simultaneously (5,6).A few decades ago, the only treatment option for metastatic gastric cancer (MGC) was best supportive care. With the increasing use of cytotoxic chemotherapy agents in various types of cancer, chemotherapy has also been used for MGC, and various studies have demonstrated the superiority of systemic chemotherapy over best supportive