Expanded Indications in Advanced Endoscopic Resection of Malignant Gastrointestinal Lesions

s: Refined histopathologic criteria, enhanced en-bloc resection through endoscopic submucosal dissection, and the introduction of endoscopic full-thickness resection have expanded curative resection to select early GI malignancies previously considered surgical. Clinical outcomes from large series demonstrate comparable long-term survival to surgery when rigorous selection and surveillance criteria are applied, while minimizing morbidity. Molecular biomarkers, artificial intelligence (AI)-based predictive models, and sentinel node mapping are promising tools to further improve risk assessment for occult LNM. Expansion of ER indications for early GI cancers is feasible and increasingly practiced in expert centers with outcomes approximating those of surgical resection. Ongoing integration of precision diagnostics, molecular profiling, and AI-driven risk models promises to further refine patient selection. However, widespread adoption should proceed within structured, evidence-based frameworks to prevent undertreatment of potentially curable disease and maintain oncologic integrity.