A total of 610 cases of early gastric cancer were studied, retrospectively. Of these, 541 (88.7%) cases were single and 62 (10.1%) cases were multiple cancers. Lymph node metastasis occurred in 11.2% of the elevated, in 8.2% of the depressed and in 15.1% of the mixed type. There was no lymph node metastasis when a mucosal or submucosal cancer was less than 10 mm in diameter. By contrast, in the cases in which the preoperative diagnosis was suspected advanced cancer, the incidence of lymph node metastasis was high, at 33%. Therefore, when the preoperative diagnosis is advanced cancer, standard radical gastrectomy and/or extended radical gastrectomy should be selected even though they are found to be early gastric cancer. The age-corrected 5-year survival rate was 98.5% in the cases with no lymph node metastasis and 93.0% in the cases with lymph node metastasis (p > 0.05). The 5-year survival rate was 100% in mucosal cancer and 95.5% in submucosal cancer (p > 0.05).