Despite major improvements in diagnosis, anesthesia, surgical techniques, and postoperative care, the survival rate for adenocarcinoma of the stomach remains a dismal one. In our series of 109 patients, almost all patients seen were diagnosed too late to effect any kind of surgical care. In the period from January 1964, to December 1974, 122 patients were admitted to Pennsylvania Hospital with a diagnosis of gastric adenocarcinoma. Of the 109 patients followed to their death, only seven survived 5 years; the longest survival was 80 months. Among the 33 patients not resected, median survival was only one month. Of the 74 patients who had surgical resections survival ranged from a median of 5.5 months for those who had total gastrectomy to a median of 8 months for those receiving subtotal gastrectomy.