ablation of all remaining BE if high-grade dysplasia (HGD) and intramucosal carci­noma (imCa) are found [5, 6]. In combination with a multidisciplinary approach in dedicated BE units [7], the efcacy and safety of endoscopic therapy in the manage­ment of HGD and early esophageal cancer have been reported as comparable to performing esophagectomies [8–10]. This has led to endoscopic therapy becoming standard of care for management of dysplastic BE and early esophageal adenocar­cinoma [11, 12].

EMR provides excellent oncologic benet in patients with BE with dysplasia and early esophageal cancer. It has been found to be safe and efcacious when com­pared to surgery, but with signicantly lower morbidity [15, 39, 44–48]. In patients with low-risk features, EMR provides 95% eradication of neoplasia and 98% 5-year survival. In those with high-risk features, complete eradication is achieved in about 80% of cases [15, 34, 38, 45, 46, 49, 50]. There is an associated risk of metachronous and recurrent lesions in about 6–30% of patients. The factors associ­ated with recurrence are larger lesions, longer BE segments, piecemeal resections, presence of multifocal lesions, and positive neoplastic margins. Most recurrences can be safely managed endoscopically [34]. Using ablative therapy like radiofre­quency ablation in combination with EMR has shown similar eradication rates. It may be useful in cases with high-risk features or piecemeal resection. Ablation does reduce the risk of bleeding, perforation, and stricture formation when com­pared to standard EMR [51].