Abstract： Objective To investigate the impact of pyloric stenosis on the prognosis after D2 radical resection for advanced distal gastric cancer.Methods Clinical data of 284 patients with advanced distal gastric cancer who underwent D2 radical resection from January 1998 to December 2004 were analyzed retrospectively.Clinicopathologic variables,survival outcomes,and postoperative morbidity and mortality were compared between patients who developed pyloric stenosis (n=69) and those without pyloric stenosis (n=215).Results The 5-year survival rate was 38.8% in patients with pyloric stenosis and 62.4% in those without pyloric stenosis,and the difference was statistically significant (P＜0.05).Cox regression model showed that pyloric stenosis,tumor size,depth of invasion,and lymph node involvement were independent predictors for survival.There were no significant differences between the two groups in postoperative morbidity (13.0% vs.10.2%,P＞0.05) or mortality (2.9% vs.1.4%,P＞0.05).Conclusions Pyloric stenosis is associated with poor survival for patients undergoing D2 radical resection for advanced distal gastric cancer.However,pyloric stenosis does not increase postoperative morbidity and mortality related to surgery.