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There is no need to conduct a time-consuming evaluation of a study's validity if it does not concretely provide a recommendation supporting the guideline. If scientific evidence claims to be internationally valid, an international committee should be able to present acceptable studies as valid and formative, eventually creating a basis for international guidelines. These studies would be able to answer some of the initially posed questions. HER2 inhibitor Services not represented in the international guidelines but included in the catalogue of national guidelines would depend on the prosperity and expectations of a country's citizens. Table 5 summarizes the five steps required to create the basis for international guidelines. Table 5 Five steps required to produce a basis for international guidelines Although many of the same study results are used to produce the different guidelines, the rational recommendations for accompanying therapy for advanced gastric cancer vary among countries, sometimes considerably. This is due to discrepancy in the interpretation of the same study results by different countries. As a great deal of effort is required for each country to separately evaluate the validity and suitability of relevant studies for inclusion in guidelines, international cooperation for the creation of a common this website basis for guidelines could facilitate their development and contribute to greater comparability.""Inflammatory myofibroblastic tumors (IMTs) are rare neoplasms that occur preferentially in children and young adults.1 IMTs most commonly occur in the lungs, mesenteries, omentum, and retroperitoneum.1,2 IMTs involving the stomach are extremely rare. These distinctive tumors are composed of myofibroblastic cells accompanied by an inflammatory infiltrate of plasma cells, lymphocytes, and eosinophils.3 IMTs present with nonspecific clinical symptoms, and their preoperative diagnosis can be difficult. IMTs in the gastrointestinal tract can Quinapyramine present with bleeding, obstruction, anemia, or intussusception, depending on the site.4 Herein, we present a case of an IMT that involved nearly the entire proximal stomach. The patient underwent laparoscopic proximal gastrectomy with double-tract anastomosis. Case Report A 28-year-old man presented with syncope and hematemesis. His symptoms were not associated with abdominal pain, dyspepsia, fever, or weight loss. The patient had no notable medical or operational history except an admission for bronchial asthma during childhood. Physical examination of vital signs revealed hypotension with tachycardia, but no other abnormalities. Hemoglobin was