Abstract: Objective To compare the overall and disease-free survival of patients with advanced gastric serosa cancer（tumor invading serosa and lymph node） after systematic intravenous chemotherapy or combined systematic and intraperitoneal chemotherapy. Methods Sixty-six patients were randomly assigned to treatment group undergoing 6 cycles of combined systematic and intraperitoneal chemotherapy and control group receiving 6 cycles of simple systematic chemotherapy. Drugs were infused into the peritoneal cavity of patients in the treatment group for the first two cycles. Disease-free survival（DFS） and overall survival（OS） as well as side effects of drugs were observed. Results DFS of patients in the treatment group was significantly longer than that of those in the control group（18.2months vs 15.4months）. However,no difference was found in OS between the two groups（24.7months vs 25months）. Conclusion Local treatment is beneficial for DFS,and OS improves depending on the whole procedure of treatment,including surgery,first and second line chemotherapy regimens and other adjuvant therapy for advanced gastric cancer.