In our western countries gastric cancer is no longer a local disease when first diagnosed in more than 55% of patients. Fairly extensive experience with extended radical procedures has failed to demonstrate any significant improvement in the 5-year survival rate. Moreover, increased operative morbidity and mortality have even aggravated our results. Subtotal gastrectomy (Billroth II) is therefore recommended for the carcinoma of the antrum, total gastrectomy (with interposition of jejunum) for carcinoma of the cardia and selected cases. Our current goal should be greater efforts towards early diagnosis to reach the results of Japanese surgeons with "early superficial cancer" of the stomach.