Severe surgery to endoscopic therapy, the therapeutic intervention for early malignant and precancerous lesions of the upper Gastrointestinal (GI) tract has changed dramatically in recent years. In the last several decades, the incidence of Esophago Gastric Junction (EGJ) adenocarcinoma has been steadily increasing in Western countries. A similar trend has been reported in Asia, owing to the availability of Helicobacter pylori (H.pylori) eradication medication, a high incidence of gastroesophageal reflux disease and obesity, and dietary variables, and partially shared with stomach cancer, H.pylori infection, and dietary factors. Endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) is a minimally invasive procedure that can cure superficial GI cancers such esophageal, gastric, and colonic lesions. Furthermore, because of the variations in the incidence of Lymph Node Metastasis (LNM) between esophageal and gastric cancer, the ESD/EMR curative resection criteria for esophageal and gastric cancer are different