Oesophageal cancer is the seventh leading cause of cancer deaths worldwide.1 In Spain, it is estimated that the number of annual cases will increase by approximately 20% over the next 20 years.1 The classic treatment for this disease has been surgery and chemoradiotherapy. In the last decade, a large number of Asian studies have confirmed that endoscopic submucosal dissection (ESD) offers favourable results in well-selected patients in both Barrett’s oesophagus (BO) and squamous lesions.2, 3, 4 In fact, recent clinical practice guidelines recommend ESD as the first-line treatment for oesophageal neoplasms affecting the mucosa or superficial submucosa, with a low risk of regional lymphatic involvement.1, 5 Compared to conventional endoscopic mucosal resection (EMR), ESD achieves greater success in terms of en bloc resection and free margins, resulting in a more accurate histological and prognostic assessment and a lower risk of recurrence.5 Additionally, case series have been reported suggesting that ESD may be indicated in less common diseases, such as adenocarcinoma arising in an inlet patch or oesophageal papillomas.6, 7, 8

Implementation of the technique in the West has been slower, probably due to a lower incidence of oesophageal cancer, lower detection of early lesions and the technical complexity of ESD.9 In addition, the risk of adverse effects is higher than with EMR, especially at the beginning of the learning curve.10 Western published results are mixed, and generally below Asian standards and those set by the European Society of Gastrointestinal Endoscopy (ESGE).11, 12, 13 In Spain, gastric ESD has been shown to yield favourable results,14 but no data have been published on the results of oesophageal ESD.

The main objective of our study was to describe the effectiveness and safety of oesophageal ESD in Spain. Our secondary objective was to analyse factors associated with non-curative resection and patient survival.