Laparoscopic Versus Open Gastrectomy for Elderly Local Advanced Gastric Cancer Patients

Inclusion Criteria:

* Ambulatory male or female aged 70 and above
* Karnofsky score≥70%
* Histologically proven gastric adenocarcinoma in biopsy (including Lauren classification) Proven clinical stage of cT2-4aNanyM0 by baseline ultrasound endoscope, enhanced CT/MRI examination, or diagnostic laparoscopy using Habermann Standards
* No past chemotherapy or radiotherapy before diagnosis
* Primary tumor located at stomach, achievable naked-eye complete resection (R0/1) via distal subtotal or total gastrectomy plus lymphadenectomy
* Haematology and biochemistry index meet the following: hemoglobin≥80g/L, absolute neutrophils count (ANC)≥1.5×109/L, platelet≥100×109/L, ALT、AST≤2.5 times the upper limit of normal value, ALP≤2.5 times the upper limit of normal value, serum total bilirubin\<1.5 times the upper limit of normal value, serum creatinine\<1 times the upper limit of normal value, serum albumin≥30g/L
* Heart and lung function can withstand surgery
* No severe concomitant disease that leads to survival\<3 years
* Willing and able to comply with study protocol Written agreement consent before enrolment and full aware of the right to quit the study at any time with no loss

Exclusion Criteria:

* Uncontrolled seizure, central nervous system diseases, or mental disorders;
* Past history of upper abdominal surgery (except for laparoscopic cholecystectomy)
* Past history of gastric surgery (including diagnosis procedure such as ESD and EMR)
* Other malignant diseases in 5 years (except for cured skin carcinoma and cervical carcinoma in situ)
* Clinical severe or active heart diseases, such as symptomatic coronary heart disease, NYHA grade II or above congestive heart failure, severe arrhythmia, or myocardial infarction in 6 months
* Cerebral hemorrhage or infarction in 6 months
* Organ transplant recipients under immunosuppressive therapy
* Severe uncontrolled repeated infection or other severe uncontrolled concomitant diseases
* Medium or severe renal damage (creatinine clearance rate≤50ml/min or serum creatinine\> upper limit of normal value)
* Other diseases requiring synchronous surgery
* Requiring emergent surgery due to oncologic emergent (e.g. bleeding, perforation, obstruction)
* FEV1\<50% of expected value Participated in other studies 4 weeks before the randomization.