Results of randomized studies and meta-analyses of the long-term results of surgical treatment of the gastric cancer with lymphadenectomy were compared. The D2 lymphadenectomy permits low indices of postoperative morbidity and mortality. The further lymphadenectomy volume increase does not lead to the significant improvement of the long term treatment results. The splenectomy and pancreas resection are not obligatory by the gastric cancer treatment and should be performed only by certain indications. The prevailing volume of surgical resection is considered to be gastrectomy; the indications to the subtotal gastric resection should be limited for the reduction of the local recurrence rate. Thereby, the optimal algorithm of the gastric cancer treatment includes the gastrectomy and D2 lymphadenectomy, accomplished by the neo- and adjuvant chemotherapy.
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