Whether a patient needs chemotherapy after total gastrectomy depends mainly on the pathological tissue examination cut down during surgery, immunohistochemistry results, and the patient’s own physical condition. If it is early stage gastric cancer, the development of the disease can be controlled through surgical resection and the treatment effect is better, so chemotherapy is generally not needed. However, in case of middle and advanced gastric cancer with more obvious symptoms, recurrence and metastasis may occur after surgery. For patients with more serious disease, the effect of surgery alone may not be satisfactory. Therefore, patients in such cases need chemotherapy adjuvant treatment after surgery. Chemotherapy after gastric cancer surgery is a more important method to consolidate the therapeutic effect of gastric cancer. Chemotherapy can prevent the recurrence or metastasis of residual cancer cells, avoid the spread of cancer cells, improve the cure rate of gastric cancer and prolong the survival of patients.