Yamada S, et al. - This multicenter study with the largest cohort attempted to determine the risk factors of early and late cancer recurrences in patients without additional surgery after noncurative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC), categorized as “noncurative resection” or “curability C-2” in the guidelines. Nine hundred five patients who were followed up without additional radical surgery after ESD for EGC categorized as curability C-2 between 2000 and 2011 were analyzed. Findings revealed that lymph invasion is primarily related early recurrence of cancer, but the vascular invasion was only a risk for late recurrence in patients without additional ESD treatment for EGC categorized as curability C-2. This finding can help to make decisions about treatment strategies after ESD, particularly in patients with a relatively short life expectancy.