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Background: 3024 elderly (≥ 60 years) with gastric carcinoma(GC) who received surgery were analyzed, then the clinicalopathological characteristics were studied, and contributing factors after surgery were analyzed.Methods: Elderly cases hospitalized in the 4th Hospital of Hebei Medical University and diagnosed pathologically as GC were collected to investigate the clinicalopathological characteristics, surgery and postoperative complications, and analyze the contributing factors of characteristics and postoperative complications.Results: Male: female ratio was 3.96∶1.Average age: (66.53±4.94) years.68.6% of tumors were on up per stomach.Ratio of advanced GC was 93.06%.Well differentiated tumor was 62.3%.Depth of invasion T4 was 78.2%; Lymph node metastasis N0 was 39.6%, N1 41.2%; Adjacent organ invaded was 7.8%, distant metastases 3.6%; Stage Ⅲ in pTNM was 72.3%.Ratio of radical surgery was 79.7%; Palliative surgery 15.2%; Bypass operation 1.7%; Exploratory surgery 3.4%.Patients with postoperative complications accounted for 6.6%.Regression analysis showed that diabetes, chronic pulmonary disease, preoperative anemia, preoperative hypoalbuminemia, combined organ excision, and surgical transfusion were independent factors for complications.Conclusion: Elderly with GC had distinctive characteristics.Surgery was the first choice for the treatment to elderly.But adequate preoperative preparation is required to decrease the complication incidence.