Some shortcomings of this study should be noted. These results were based on clinical data obtained from an eastern country at a single institution. Eastern countries have higher GC morbidity and more advanced-stage GC patients than western countries. Moreover, the average BMIs in eastern countries are lower than those in western countries. The results showed there is no significant difference in No. 10 LN metastasis between the patients with and without neoadjuvant chemotherapy, regardless of the modeling or validation group, which proving that the neoadjuvant chemotherapy didn't change the original status of No. 10 LNs. Therefore, a prospective multiple-center study with a large population would help validate this scoring system in a sample of patients from both eastern and western countries.