A study of 1,994 patients with advanced gastric cancer operated on with curative intent who were followed prospectively demonstrated a cumulative 5-year survival of 52.8% and a relapse rate of 34.5%. Peritoneal dissemination dominated the mode of recurrence (44.2%), followed by local (23.0%), liver (13.8%) and distant metastases (10.6%). Most frequently the differentiated type of cancer recurred in liver and peritoneal cavity, but the undifferentiated type of cancer recurred in peritoneal cavity. This difference in the distribution of recurrence was statistically significant (p