Generally speaking, it is necessary to judge whether chemotherapy is needed according to the condition of patients after total gastrectomy, such as patients with advanced gastric cancer with recurrence possibility and patients with progressive gastric cancer. 1. For advanced gastric cancer patients with the possibility of recurrence, chemotherapy after total resection may be able to slow down the development of tumor and improve the symptoms, etc. Its purpose is to control the remaining tumor cells to reduce the chance of recurrence. 2. Patients with advanced gastric cancer need chemotherapy after total excision with or without lymph node metastasis, and when implementing chemotherapy, it is necessary to make sure that the patient is in good general condition, the function of other organs is normal and there is no serious complication. In all the above cases, reasonable and standardized diagnosis and treatment should be carried out under the guidance of professional doctors.