Surgeons should note that achieving the Textbook Outcome in gastric cancer surgery significantly enhances patient survival and reduces hospital stays.

• 74.7% of 5806 patients achieved the Textbook Outcome, with 87.6% 5-year survival for those who did.
• Success rates varied by stage: 77.9% for stage I and 68.8% for stages II-III.

Older patients had lower achievement rates; 82.3% for those under 40 vs. 67.5% for those over 80.

Consider factors like early lesions, female sex, and minimally invasive techniques to optimize outcomes.