Pessorrusso FCS, et al. - In a 39-year retrospective cohort, researchers assessed gastrectomy specimens, including lymph node metastases (LNMs) staging of patients submitted to gastrectomy for early gastric cancer (EGC), to evaluate the risk of LNM in gastrectomy specimens of patients with EGC who met the expanded criteria for endoscopic submucosal dissection (ESD). For this investigation, 389 surgical specimens were involved. A small risk of LNM in EGC was noted when expanded criteria for ESD were met. In the Brazilian cohort, refining the expanded criteria for the risk of LNM could be desirable. Results of this study suggested that the individual risk of perioperative morbidity and mortality should be considered with the decision to complement endoscopic treatment with gastrectomy.