|Chemotherapy is the standard treatment for advanced gastric cancer with non-curable factors, such as peritoneal or hepatic metastases. However, gastrectomy may be the preferred procedure even for these patients, based on the results of retrospective studies showing some survival benefits. We therefore initiated an international randomized controlled trial (REGATTA trial) to evaluate the role of gastrectomy in advanced gastric cancer with a single non-curable factor. A total of 175 patients (95 in Japan, 79 in Korea, 1 in Singapore) were enrolled in this trial between Feb 2008 and Aug 2013, and the primary results were published in 2016. Here, I introduce the primary results of this trial and the way to success in conducting an investigator-initiated trial among Asian countries.