Li Z, et al. - The safety and long-term prognosis of distal gastrectomy (DG) with total gastrectomy (TG) for middle- and lower-third gastric cancer were determined. TG led to a higher rate of overall post-operative complications, anastomosis leakage, wound complications, peritoneal abscesses, and mortality in comparison to DG. Thus, for middle- or lower-third gastric cancer in early and locally advanced stages, DG is an optimal surgical procedure with better short-term outcomes. DG and TG had comparable long-term prognosis under the precondition of negative proximal resection margin.