It is widely known that the CLASSIC trial (1) was the first international phase III study to investigate the effectiveness of adjuvant chemotherapy over surgery alone after D2 dissection of gastric cancer in an Asian population. In this trial, the incidence of hand-foot syndrome (HFS) was 1%. Many re-ports have suggested that HFS may be a valuable tool with which to evaluate and monitor the efficacy of capecitabine in patients with colorectal cancer and breast cancer (2-4). It is undetermined that HFS as a tool to evaluate and monitor the drug efficacy can obtain the same results in post-operative stomach cancer patients. The use of existing data from the CLASSIC trial to identify an association between HFS and the efficacy of capecitabine in patients with stomach cancer is considered viable. However, many objective difficulties stand in the way.