Stomach cancers are diagnosed at an early stage in less than 10% of cases in Europe. They are superficial tumours, involving the mucosa and the submucosa only. Node involvement is the most important prognostic factor for these tumours. To determine the optimal therapeutic strategy, it is necessary to carry out a precise work-up involving an endoscopy, with chemical or virtual colorations and an echo-endoscopy. Gastric surgery is the reference treatment. Nowadays, endoscopic tumour resection is a validated curative alternative. High quality medical expertise is needed for those tumours with a good prognosis, after evaluating risk for node involvement, and should be followed by Helicobacter pylori eradication and regular endoscopic surveillance.