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改善可切除胃癌的预后关键在于彻底的淋巴结清扫和辅助抗肿瘤治疗。根据日本资料,D2-3切除术(N_2和N_3组淋巴结清扫）治疗主要失败于腹膜面和肝转移,而美国的资料提示40％的首见复发灶是在局部区域。半数以上的复发发生在术后2年内,1/3则发生3～5年内。早期复发也以肝转移和腹膜播散为多见. Koga提出肝转移发生最早（2年内达81%), 而肺和骨转移发生较晚（66％在2年后）。从组织学观点,淋巴结转移取决于肿瘤浸润深度,而与其肿瘤类型无关;但肝转移和腹膜播散则与肿瘤的组织学类型有关。如肝转移多见肠型胃癌（50％～70％）,少见于弥漫型胃癌（3％～30％）;腹膜种植则多见于弥漫型胃癌（45％～75%) 而少见于肠型胃癌（10％～30％）。
The key to improving the prognosis of resectable gastric cancer is thorough lymph node dissection and adjuvant anti-tumor therapy. According to the Japanese data, D2-3 resection (N_2 and N_3 lymph node dissection) treatment mainly fails in peritoneal surface and liver metastases, while US data suggest that 40% of first-episode recurrent foci are in local areas. More than half of the recurrences occurred within 2 years after surgery, and 1/3 occurred within 3 to 5 years. Early recurrence is also common with liver metastasis and peritoneal dissemination. Koga proposed that liver metastases occurred earliest (81% within 2 years), while lung and bone metastases occurred later (66% after 2 years). From a histological point of view, lymph node metastasis depends on the depth of tumor invasion, but not on its tumor type; however, liver metastases and peritoneal dissemination are related to the histological type of the tumor. Such as liver metastases, intestinal gastric cancer (50% ~ 70%), rare in diffuse gastric cancer (3% ~ 30%); peritoneal cultivation is more common in diffuse gastric cancer (45% ~ 75%) and rare in intestinal type gastric cancer (10% to 30%).