From June 1972 to December 1993, 280 patients underwent surgical resection for their gastric cancer extending to adjacent organs. The patients were divided into three groups. Group A, 93 patients, were treated with gastrectomy plus complete removal of the invaded organs. Group B, 55 patients, underwent gastrectomy with incomplete removal of the invaded organs. Group C, 132 patients underwent gastrectomy only. The 5 year survival rate of each group was 32.7%, 7.7% and 4.4%, respectively. The 5 year survival rate in the group A was significantly higher than that in two other 2 groups (P < 0.05). The 5 year survival rate in the group B and C was similar (P > 0.05). The patients without incurable factors (liver metastasis, peritoneal dissemination and widespread nodal involvement) underwent gastrectomy with complete excision of invaded organs, irrespective of the number or site of invaded organs. On the other hand, the patients with incurable factors should be given palliative gastrectomy only. Because symptoms are alleviated, the quality of life is improved and the survival time is prolonged.