ABSTRACT
Gastric cancer is one of the most common malignant tumors in the digestive system. At present, surgery is still the main treatment for gastric cancer and the consensus has been reached that D 2 lymph node dissection should be performed for advanced gastric cancer. Laparos-copic distal gastrectomy for locally advanced gastric cancer completed by experienced surgeons was comparable to open surgery in terms of safety and oncology. Laparoscopic spleen preserving splenic hilar lymph node dissection is safety and effective. Adjuvant chemotherapy and neoadjuvant chemo-therapy can prolong postoperative survival time of gastric cancer patients. The common chemo-therapy regimens are single drug S-1, XELOX regimen or S-1 combined with docetaxel. DOS regimen, SOX regimen and FLOT regimen are commonly used neoadjuvant chemotherapy regimens. Molecular targeted drugs or immunotherapeutic drugs has not been approved for the perioperative first-line treatment of locally advanced gastric cancer, but more and more clinical research results suggest that the combination of targeted therapy or immunotherapy can improve the R 0 rate or pathological complete response rate. There is no evidence to support that combination treatment can prolong survival time. The best comprehensive treatment for advanced gastric cancer is not unified, which needs further researches.