AIM To investigate the outcomes and recurrences of p T1 b esophageal adenocarcinoma(EAC) following endoscopic mucosal resection(EMR) and associated treatments.METHODS Patients undergoing EMR with pathologically confirmed T1 b EAC at two academic referral centers were retrospectively identified.Patients were divided into 4 groups based on treatment following EMR:Endoscopic therapy alone(group A),endoscopic therapy with either chemotherapy,radiation or both(group B),surgicalresection(group C) or no further treatment/lost to follow-up(<12 mo)(group D).Pathology specimens were reviewed by a central pathologist.Follow-up data was obtained from the academic centers,primary care physicians and/or referring physicians.Univariate analysis was performed to identify factors predicting recurrence of EAC.RESULTS Fifty-three patients with T1 b EAC underwent EMR,of which 32(60%) had adequate follow-up ≥ 12 mo(median 34 mo,range 12-103).There were 16 patients in group A,9 in group B,7 in group C and 21 in group D.Median follow-up in groups A to C was 34 mo(range 12-103).Recurrent EAC developed overall in 9 patients(28%) including 6(38%) in group A(median:21 mo,range:6-73),1(11%) in group B(median:30 mo,range:30-30) and 2(29%) in group C(median 21 mo,range:7-35.Six of 9 recurrences were local;of the 6 recurrences,5 were treated with endoscopy alone.No predictors of recurrence of EAC were identified.CONCLUSION Endoscopic therapy of T1 b EAC may be a reasonable strategy for a subset of patients including those either refusing or medically unfit for esophagectomy. AIM To investigate the outcomes and recurrences of p T1 b esophageal adenocarcinoma (EAC) following endoscopic mucosal resection (EMR) and associated treatments. METHODS Patients undergoing EMR with pathology confirmed T1 b EAC at two academic referrals centers were retrospectively identified. Patients were divided into 4 groups based on treatment following EMR: Endoscopic therapy alone (group A), endoscopic therapy with either chemotherapy, radiation or both (group B), surgical procedure (group C) or no further treatment / lost to follow-up (<12 mo) (group D). Pathology specimens were reviewed by a central pathologist. Frohled-up data was obtained from the academic centers, primary care physicians and / or referring physicians. Univariate analysis was performed to identify factors predicting recurrence of EAC. RESULTS Fifty-three patients with T1 b EAC underwent EMR, of which 32 (60%) had adequate follow-up ≥ 12 mo (median 34 mo, range 12-103) .There were 16 patients in group A, 9 in group B, 7 in group C and 21 in group D. Median follow-up in groups A to C was 34 mo (range 12-103). Current EAC developed overall in 9 patients (28%) including 6 (38%) in group A range: 6-73), 1 (11%) in group B (median: 30 mo, range: 30-30) and 2 recurrences were local; of the 6 recurrences, of the 5 were treated with endoscopy alone. No predictors of recurrence of EAC were identified. CONCLUSION Endoscopic therapy of T1 b EAC may be a reasonable strategy for a subset of patients including those either refusing or medically unfit for esophagectomy.