The prognosis of early gastric cancer (EGC) is excellent worldwide. Incidence of EGC shows considerable geographic variation, and in high prevalence areas where diagnostic skills are adept, EGCs are not frequently overlooked. In these countries, less invasive, function-preserving treatments such as endoscopic mucosal resection and pylorus-preserving gastrectomy have become standard options. The criteria to apply conservative treatments are being expanded along with the technological improvement. Though its natural history is relatively long, EGC could be a fatal disease and should be carefully treated. Lymph node metastasis is the most important prognostic factor that should be considered in treatment selection and follow-up planning of EGC.
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