Although several prognostic indicators for gastric carcinoma have been reported, characteristics of long-term survivors with advanced gastric carcinoma have not yet been clarified. We compared clinicopathologic features of 54 patients who survived for >10 years after resection for advanced gastric carcinoma with those of 72 patients who died of recurrence. Long-term survivors were characterized by small tumor size (6.2 cm vs. 8.1 cm, p < 0.01), negative serosal invasion (50% vs. 32%, p < 0.05), few lymph node metastases (fewer than seven) (89% vs. 56%, p < 0.01), limited lymph node metastases (n0, n1) (89% vs. 40%, p < 0.01), and earlier stage (I or II) (50% vs. 16%, p < 0.01). These results indicate that small tumor size, negative serosal invasion, and fewer than seven positive nodes were the predictors of long-term survival after resection for advanced gastric carcinoma.