AbstractA series of 536 patients who underwent gastric resections for advanced gastric cancer has been reviewed with regard to the diagnostic procedures for detecting gastric cancer. There were no characteristic symptoms of gastric cancer, but weight loss was a frequent complaint. Variation in the type and frequency of symptoms did not appear to depend on the presence or absence of metastases. Patients whose operations were delayed more than one year after the onset of symptoms accounted for 33% of the series, and 38% of these had visited their physicians within 6 months after the onset of symptoms but were misdiagnosed as having chronic gastritis or benign ulcer. The results of various laboratory examinations were not specific. Gastric acidity was found to be distinctly lower than in patients with benign gastric disease. Techniques of radiology, endoscopy, and endoscopic biopsy of the stomach have greatly improved, and the overall rates of correct diagnosis of gastric cancer were 96% by x‐ray, 98% by endoscopy, and 90% by biopsy. These rates were slightly lowered when only Borrmann type IV lesions were considered. Celiac angiography was useful to determine the extent or depth of cancerous invasion and to detect liver metastases. The frequency of positive PPD or DNCB skin tests appeared to decrease as the stage of cancer advanced, indicating immunologic impairment in advanced gastric cancer.