“…Conversely, T1b cancers are considered to be better managed with esophagectomy owing to the risk of lymph node metastasis (LNM). Surgery has also been shown to improve overall survival compared with EMR for T1b tumors 3 . While the risk of LNM with T1a cancer is negligible, favoring endoscopic resection due to its low risk of morbidity and mortality, the risk of LNM for T1b cancer is not clear.…”