Adequate surgical radicality in regard to the extent of gastric resection as well as to systematic lymphadenectomy with the aim of R-0-resection is the treatment of choice in gastric carcinoma. The demand for such a procedure based on the results obtained in the last years with increasing rates of resectability together with decreasing operative mortality. In the own material among a total of 1704 operations for gastric carcinoma the rate of resectability raised from 70% to 81.5% whereas overall operative mortality fell from 17.5% to 4.7%. The 5-year survival rate following different resective procedures was 26%; if these results can be improved by perioperative chemotherapy must be verified by running multimodality treatment studies.