Of 220 patients operated for gastric cancer, 74 with subtotal gastrectomy and 145 with total gastrectomy (60 with lymphadenectomy), the results and indications for total gastrectomy extended with lymphadenectomy are analysed. The importance of lymph node emptying in relation to the possibility of breakdown of the lymphnode chains with R2 metastasis is particularly stressed. Analysis of perioperative mortality and long-term survival indicates results that are close to the data reported by Japanese schools.