AIM:To analyze the factors influencing the prognosis ofpatients with gastric cancer after surgical treatment,in orderto optimize the surgical procedures.METHODS:A retrospective study of 2 613 consecutive patientswith gastric cancer was performed.Of these patients,2301(88.1%)received operations;296 explorative laparotomy(EL),130 by-pass procedure(BPP),and 1975 surgicalresection of the tumors(891 palliative resection and 1084curative resection).The survival rate was calculated by theactuarial life table method,and the prognostic factors wereevaluated using the Cox regression proportional hazard model.RESULTS:Of the patients,2 450(93.8%)were followed-up.The median survival period was 4.6 mo for patients withoutoperation,5.2 mo for EL,6.4 mo for BPP,and 15.2 mo forpalliative resection(P=0.0001).Of the patients withsurgical resection of the tumors,the overall 1,3 and 5-yearsurvival rates after were 82.7%,46.3% and 31.1%,respectively,with the 5-year survival rate being 51.2% inpatients with curative resection,and 7.8% for those withpalliative resection.The 5-year survival rate was 32.5% forpatients with total gastrectomy,and 28.3% for those withtotal gastrectomy plus resection of the adjacent organs.Thefactors that independently correlated with poor survivalincluded advanced stage,upper third location,palliativeresection,poor differentiation,type IV of Borrmannclassification,tumor metastasis(N_3),tumor invasion into theserosa and oonUguous structure,proximal subtotal gastrectomyfor upper third carcinoma and D_1 lymphadenectomy aftercurative treatment.CONCLUSION:The primary lesion should be resected aslong as the local condition permitted for stage Ⅲ and Ⅳtumors,in order to prolong the patients’ survival and improvetheir quality of life after operation.Total gastrectomy isindicated for carcinomas in the cardia and fundus,andgastric cancer involving the adjacent organs without distantmetastasis requires gastrectomy with resection of the involvedorgans. AIM: To analyze the factors influencing the prognosis of patients with gastric cancer after surgical treatment, in orderto optimize the surgical procedures. METHODS: A retrospective study of 2 613 consecutive patients with gastric cancer was performed. Of these patients, 2301 (88.1%) received operations ; 296 explorative laparotomy (EL), 130 by-pass procedure (BPP), and 1975 surgical review of the tumors (891 palliative resection and 1084 curative resection). The survival rate was calculated by the actuarial life table method, and the prognostic factors wereevaluated using the Cox regression proportional hazard model .RESULTS: Of the patients, 2 450 (93.8%) were followed-up.The median survival period was 4.6 mo for patients withoutoperation, 5.2 mo for EL, 6.4 mo for BPP, and 15.2 mo forpalliative resection ( P = 0.0001). Of the patients with resected resection of the tumors, the overall 1,3 and 5-yearurvival rates after were 82.7%, 46.3% and 31.1%, respectively, with the 5-year survival rate being 51.2% inpatients with curative resection, and 7.8% for those with palliative resection. The 5-year survival rate was 32.5% for patients with total gastrectomy, and 28.3% for those with total gastrectomy plus resection of the adjacent organs. Thesefactures that independently correlated with poor survivalincluded advanced stage, upper third location, palliativeresection, poor differentiation, type IV of Borrmannlassification, tumor metastasis (N_3), tumor invasion into theserosa and oonUguous structure, proximal subtotal gastrectomyfor upper third carcinoma and D_1 lymphadenectomy aftercurative treatment.CONCLUSION: The primary lesion should be resected as long as the local condition permitted for stage Ⅲ and Ⅳtumors, in order to prolong the patient ’survival and improvetheir quality of life after operation. Total gastrectomy isindicated for carcinomas in the cardia and fundus, andgastric cancer involving the adjacent organs without distant metastasis requires gastrectomy with resection of the involvedorgans.