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8years, 4 patients (2%) developed MGC. Median time to MGC occurrence was 4.5years (range 3.1-5.4). Five-year cumulative incidence of MGC was 1.0% (95% CI 0.2-3.3%). Two MGCs were histologically D-EGC, and the remaining two were UD-EGC. The median tumor size of MGCs was 1.0cm (range 0.7-1.7), and the depth of invasion (M/SM1/SM2) was 2/1/1, respectively. Three patients achieved curative resection with repeated ESD. MGC does not occur commonly after curative ESD of UD-EGC, and repeated ESD could contribute to stomach preservation. MGC do