The optimal procedure for the lower third gastric adenocarcinoma is still an open question. We performed an analysis of the long-term survival of patients after subtotal (SG) or total gastrectomy (TG) on 164 enrolled patients. Bivariate and multivariable analyses were performed in order to identify characteristics associated with long-term survival. Survival was significantly affected by the number of positive lymph nodes (LN). Patients who have undergone TG had a higher number of total removed LN. The adjusted hazard ratio for the TG group suggests a partial superiority of TG over SG for patients with curative intent. Our data support the importance of extended LN dissection.