With great interest, we read Li and colleagues’ article1 in this issue of JAMA Surgery. The authors sought to compare the short-term outcomes of laparoscopic distal gastrectomy with those of open distal gastrectomy for the treatment of patients with locally advanced (cT2-4aN+M0) distal gastric cancer. In this study, an open-label, single center, phase 2 randomized clinical trial with a noninferiority design, the authors assessed outcomes at 3 years. All patients received neoadjuvant therapy of oxaliplatin and capecitabine before their operation. Li and colleagues1 reported significantly lower postoperative complication rates, less postoperative pain, and better adherence to and completion of adjuvant therapy among trial participants.