During 20 years from 1971 to 1990, 605 patients with gastric cancer were treated by gastric resection at a medium-size general hospital by one surgeon. The overall 5-year survival rate was 61.9%. The 5-year survival rates in the first 10 years (n = 261) and the second 10 years (n = 344) were 53.7% and 67.9%, respectively (P < 0.01). In the second 10 years there was a significant increase in the patients with early gastric cancer (P < 0.01). Meanwhile, operative procedure or R2 or R3 lymph node dissection did not show any improvement of the 5-year survival rates. These results indicate that the prognosis for gastric cancer was relatively good at a general hospital which does not specialize in cancer research, and that much of the improvement in the prognosis could be attributed to the increase in the incidence of patients with early gastric cancer.