This article discusses the outcomes of different treatment approaches after R0 endoscopic resection (ER) of high-risk T1 esophageal adenocarcinoma (EAC). The study aimed to assess the outcomes following R0 ER for high-risk T1 EAC, specifically looking at the risk of lymph node metastases (N+). The study found that the majority of cases with surgical T1 had ER misclassified as R0, challenging previous studies that reported higher N+ rates. The results suggest that surgery is not a definitive curative approach and did not improve disease-specific mortality. Further research is needed to evaluate outcomes in patients treated endoscopically for high-risk T1 EAC. [Extracted from the article]