In Japan, elderly gastric cancer(GC)patients have been rapidly increasing, and in 2020 when the babyboomers' GC incidence reaches its peak, the number of deaths due to GC will reach seventy thousand per year. Few clinical trials have been done for surgery and chemotherapy for GC so far, and little information is available on the risk benefit for elderly patients. Reports from single institutes described comparable efficacy and safety, while a large national database indicates age as an independent risk factor. Similarly, little study and information are available on chemotherapy for elderly with GC. In future, standardization of comprehensive geriatric assessment(CGA)and preoperative risk assessment in clinical trials with risk-stratified protocol treatment, and a large surgical database with similar standard risk assessment are warranted.