The only curable therapy option is early diagnosis and surgical resection of the carcinoma (standard procedure: Gastrectomy) with a large safety area. The procedure should be radical and the size of the safety area is topic of discussion.The usual procedure includes removal of the tumor with 5 cm safety distance for the intestinal type and 8 cm for the diffuse type. Simultaneously the surgery includes a systematic dissection of the lymph nodes as well as resection of the omentum majus and minus. Splenectomy is not necessary in all cases. The early carcinoma of the stomach shows the best survival rates after resection of the tumor as well as the regional lymph nodes. 5-year survival rates are up to 80% here. More progressed tumors, detected late, have a very poor survival rate of less than 20 % for the next five years.Tumors, which are initially non- resectable can be treated with chemotherapy to reduce tumor mass and make them available for surgery. Far progressed tumors without any hope of complete removal may be treated with resection of the stomach, endoscopic laser ablation or proximal stenting for palliative reasons. A radio- or chemotherapy may be also included here to control tumor mass.