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BACKGROUND Standard treatment for stage II/III gastric cancer is curative resection followed by adjuvant chemotherapy. However, the five-year survival remains unsatisfactory. Inhibin βA (INHBA) has been reported to be associated with cancer cell proliferation and chemoresistance. PATIENTS AND METHODS We studied the clinical significance of INHBA gene expression in 134 patients with stage II/III gastric cancer who received adjuvant chemotherapy with S-1. INHBA expression of specimens of cancer tissue and adjacent normal mucosa was measured by quantitative real-time, reverse-transcription polymerase chain reaction (RT-PCR). RESULTS INHBA expression levels were significantly higher in cancer tissue than in adjacent normal mucosa. High INHBA expression was associated with significantly poorer 5-year survival than was low expression. On multivariate analysis, INHBA expression was an independent prognostic factor. CONCLUSION INHBA gene expression in gastric cancer tissue is considered a useful independent predictor of outcomes in patients with stage II/III gastric cancer who receive adjuvant chemotherapy with S-1.