This document analyzes treatment plans for patients with locally advanced gastric cancer. 144 patients underwent surgery to remove their stomach and nearby organs. Patients who received adjuvant chemotherapy after surgery had a significantly higher 5-year survival rate of 69.3% compared to 35.1% for patients who only had surgery. Neural network modeling revealed that 5-year survival was most dependent on the extent of lymph node involvement. The optimal management strategies identified were experienced surgeons for complex surgery, complete removal of the tumor and lymph nodes during surgery, precise prediction of prognosis, and adjuvant treatment for high-risk patients.