This 62 year-old-female with history of 1. Spondylolisthesis over over L4-5, Gr. I, with bilateral radiculopathy s/p L4-5 bilateral dacetectomy and right TLIF; 2. DM According to the patient's statement, she had sorness then she went LMD ENT and was told GERD was suspected, then she went to Chen-Chin H. for upper Gl scope at May and was told GERD. After took PPI for severy months, she had upper Gl scope for follow up at november and biopsy revealed gastric adenocarcinoma. Therefore, he went to our hospital for further management. Under the impression of Gastric adenocarcinoma, she was admitted for pre-op survey