Gastric cancer without metastasis in early and middle stages needs to be judged whether chemotherapy is needed according to specific conditions. Surgery is recommended as the first choice. If there are high risk factors for recurrence, chemotherapy should be assisted. 1. Early gastric cancer: Early gastric cancer often has no metastasis, and after radical surgical resection, its cure rate is more than 80%, and there are no obvious high-risk factors for recurrence, so chemotherapy can be avoided. 2. Intermediate gastric cancer: Intermediate gastric cancer generally refers to progressive gastric cancer, if only surgical treatment is carried out, the incidence of local recurrence or distant metastasis is high, so it is generally recommended to carry out adjuvant chemotherapy, and can also be combined with radiotherapy and immunotherapy to control the condition. Early and middle stages of gastric cancer should be treated as early as possible, and the most suitable treatment plan should be chosen under professional doctor’s advice to improve the cure rate.