Objectives: To determine whether or not the survival of patients undergoing surgical resection for gastric cancer was influenced by clinical presentation and/or pathological staging. Materials and Methods: The Loyola Cancer Registry was accessed for information regarding 93 consecutive patients who had undergone gastric resection for gastric adenocarcinoma between July 1994 and January 2004. Survival data was obtained for all patients through September 2004. Patient charts were reviewed for clinicopathologic variables leading to further diagnostic testing, perioperative events and complications and postoperative adjuvant therapy. Pathology reports from resected specimens were reviewed for tumor staging and histological markers. The SPSS program was utilized to perform multivariate and univariate analyses relating survival to symptoms, nodal status, tumor stage, tumor size and margin status. Results: There were 62 men (median age=71) and 31 women (median age=75). The median follow-up time for patients still alive was 20 months. Of the presenting clinical symptoms of weight loss, nausea/vomiting, abdominal pain, and early satiety, only weight loss (n=27) was associated with a significantly worse prognosis with a median survival of 13 months versus 44 months in patients with no weight loss (p=0.0155). Lymph node status was associated with a worse median survival only in those patients (n=43) in whom at least 15 nodes were identified (14 months for node positive disease vs. median survival not reached for node negative disease). Median survival of patients with positive margins (n=38) was significantly less than patients with negative margins (n=55), (22 months vs. not yet reached for patients with negative margins, p=0.0206). Lymphovascular invasion on histological analysis was associated with shorter median survival time than without invasion (14 months vs. 58 months, p=0.0068). Comparison of survival among patients from each tumor stage (T1 through T4) showed significant differences (T1, n=16, 63 months;T2, n=39, 33 months;T3, n=35, 15 months;T4, n=3, 5 months, p=0.0007). On multivariate analysis only tumor stage significantly influenced survival in our patients (p=0.03; CI: 1.04-2.3). Conclusions: Weight loss at presentation implies a significantly worse prognosis in patients with gastric adenocarcinoma. Lymphovascular invasion and positive margins conferred a shorter median survival time when considered as independent factors. Our data confirms previously reported observations that gastric adenocarcinoma of advanced tumor stage adversely affects survival in patients undergoing resection.