Dukes' classification for colorectal cancer is easy to remember and accurate in estimating survival. The Japanese definition of early gastric cancer have some problems, since it includes node-positive cases showing a worse prognosis. The aim of this study was to clarify whether or not Dukes' A tumor can be used as new criteria for early gastric cancer. Using 217 patients who underwent radical gastrectomy and lymph node dissection for primary gastric adenocarcinoma, long-term results and cumulative survival rates after operation were examined. Patients consisted of three groups: Group 1, 20 patients with node-negative tumor invading down to the muscularis propria, Group 2, 175 patients with node-negative tumor limited to the mucosa or submucosa, and Group 3, 22 patients with node-positive tumor limited to the mucosa or submucosa. The 10-year survival rates for Group 1, Group 2, and Group 3 patients were 94.7%, 96.9%, and 85.1%, respectively. The survival rate of Group 3 patients was significantly lower than that of Group 1 and Group 2 patients (p<0.05). The prognosis of patients with Dukes' A tumor (Group 1 plus Group 2) was excellent, showing 10-year survival rate of 96.6%. Mucosal or submucosal cancer brought a poor prognosis when there was lymph node metastasis. Early gastric cancer would better be defined as a Dukes' A tumor which includes node-negative tumor not beyond the muscularis propria.

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