Abstract: Stage Ⅳ gastric cancer is defined as gastric cancer with noncurative factors, and the longterm survival rate of patients with stage Ⅳ gastric cancer is around 10%. Chemotherapy has been used for the main therapy of the patients with unresectable stage Ⅳ gastric cancer. Palliative resection of the primary tumor has been recommended only for presence of obstruction, bleeding and other surgical emergency. Debulking operation was irrelevant to the outcome that has been considered by research results. However, the patients with stage Ⅳ gastric cancer of only one noncurative factors (No.16a2, b1 lymph node enlargement; degree of peritoneal metastasis as P0 and positive peritoneal cytology; a small number of liver metastases) have good longterm survival when these patients have achieved R₀ or R₁ resection. In this regard, comprehensive treatment including surgical resection is the main treatment policy for the patients with stage Ⅳ gastric cancer. In recent years, some clinical studies on improvement of prognosis through surgical resection after conversion therapy have received extensive attention.