Even though the incidence of gastric carcinoma is decreasing, the prognosis remains poor. A review of 88 patients with advanced gastric cancer was evaluated by univariate and multivariate analysis to determine prognostic factors. Univariate analysis showed that both "curative" resection (P = 0.006) and adjuvant chemotherapy (P = 0.02) were important therapy variables. These factors were not independent when evaluated by multivariate analysis. However, when they were combined and re-evaluated by multivariate analysis, the combination of "curative" surgery and adjuvant chemotherapy significantly improved survival in advanced gastric cancer (P = 0.04).