In advanced gastric cancer, palliation of symptoms, rather than cure, is often the most appropriate goal of patient management. There are important differences among patients undergoing non-curative operations for gastric cancer. The literature to date is limited, in part, by imprecise use of the term palliative. In clinical decision-making, the potential benefits of proposed procedure must be balanced against the duration of hospitalization, treatment of complications, and requirements for additional palliation. Studies designed to measure palliative interventions would benefit from precise designations of palliative intent inpatients receiving non-curative operations.