Gastric cancer is the fifth most prevalent male cancer and the sixth most prevalent female cancer. Although its prevalence is slowly declining in western countries, the mortality asso­ciated with it is still high and even reaches the incidence found in some endemic areas. These facts are daunting, especially considering the fact that in the majority of cases in Slovenia diagnosis is still made in a desperate stage. A slightly positive trend toward early diagnosis has been seen in recent years, but these patients represent less than a quarter of all cases. The multimodal approach to treatment has enabled long term survival of gastric cancer patients. In specialized centers, the 10-year survival after curable resections has been reported to be 36%. These outstanding results are also matched in Slovenia, owing to interdisciplinary coopera­tion, continuous education, keeping up with oncological trends, and, finally, our own research. At the undisputed top are the Japanese with a cumulative 5-year survival of 70%. Their results are a milestone that will be difficult for others to reach and the reasons for this are diverse. In the following article, the authors provide a comprehensive overview of gastric cancer dis­ease from the surgical perspective, substantiated by experience from the treatment of 772 patients at the Maribor University Clinical Centre in the period from 1 January 1992 to 31 July 2009. In 657 cases, R0 resection was accomplished and the 5-year survival for the stud­ied 18-year period in patients with curable resection amounted to 42%.