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tion in the treatment of EGC has risen. The possibility of en bloc endoscopic resection regardless of lesion size, preserving the stomach’s integrity, with a low complication rate, has made ESD the desired minimally invasive treatment for EGC [2] . Compared with surgery, a recent systematic review documented a lower morbidity for ESD and a similar 5-year survival [3] . These outstanding results of ESD in EGC have been observed not only in Asia but also in reference centers in Western countries [4, 5] . With the emergence of this new therapeutic option for EGC, new challenges have risen. In this issue of GE Port J Gastroenterol , Libânio et al. [6] review their experience in a large series of ESDs for EGC (194 lesions in 164 patients) with long-term follow-up (median follow-up time, 40 months), focusing on 3 important aspects of this technique: 1. Preprocedural risk for noncurative resection/patient selection; 2. Approach to metachronous lesions; 3. Management after noncurative endoscopic resection. This monocentric Portuguese study has the largest cohort with the longest follow-up in Europe and brings us original new data on these 3 subjects.

Clinical Management after Endoscopic Submucosal Dissection for Early Gastric Cancer: Sticking to the Gastroenterologist May Be the Best Option!