Endoscopic Submucosal Dissection (ESD) provides an advanced local treatment option for early upper gastrointestinal carcinomas, enabling complete tumor removal and improved patient outcomes.

• ESD allows for en bloc resection of early GI neoplasia, aiding in precise pathology and risk assessment.
• Key candidates for ESD include high-grade intraepithelial neoplasia and superficial early carcinomas without visible deep invasion or lymph node metastasis risk.

Thoughtful patient selection using high-definition imaging is crucial to maximize ESD benefits.

• Consider additional surgery for tumors with deep invasion or poor differentiation, guided by validated risk scores.