To investigate the role of preoperative IHC in advanced gastric carcinoma, clinical, surgical and pathological stagings of 13 patients were analysed retrospectively. These patients were treated with a 3-drug combination of adriamycin, 5-fluorouracil and mitomycin C under angiotensin II induced hypertensive state. The response rate was 69.2% and mean survival time was 850.2 days. "Down staging" in surgical stage was observed in 5 out of 13 cases (38.3%), and in pathological stage 7 cases (53.8%) "down staging" was achieved. Mean survival time of "pathological down-staging" cases was significantly longer than that of "non-down-staging" cases (1039.6 vs 322.1 days, p less than 0.01, generalized Wilcoxon test). IHC brings selective increase of drug delivery to tumor tissue, and will be useful as preoperative chemotherapy in advanced gastric carcinoma in terms of "down staging".