Since endoscopic treatment has been evaluated and become established as treatment for early gastric cancer, metachronous recurrence has become a major problem. In this report, predictive factors for recurrence were studied using the Kaplan-Meier method and Cox's proportional hazards regression model in 76 patients who received endoscopic treatment. There were 48 men and 28 women age 69.6 +/- 8.3 years (mean +/- standard deviation), 5 of whom had synchronous multiple lesions and 71 who had a single lesion found during the initial endoscopic treatment. In all patients, periodic follow-ups were performed by endoscopy for more than 2 years after treatment. Helicobacter pylori infection was assessed in 55 of the 76 patients, and proved positive in 43 and negative in 12. Metachronous recurrence was detected significantly more frequently in patients whose synchronous multiple lesions were found during the initial treatment. In addition, age affected the recurrence positively. However, gender and H. pylori infection had no significant relationship with metachronous recurrence.