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Background: Missed lesions are common during standard colonoscopy and are correlated with post-colonoscopy colorectal cancer. Contrast-enhanced technologies have recently been developed to improve polyp detection. We aimed to evaluate the impact of linked color imaging (LCI) on the proximal adenoma miss rate in routine colonoscopy., Methods: This national, multicenter, tandem, randomized trial compared the outcomes of colonoscopy with white-light imaging (WLI) versus LCI for polyp detection in the right colon. Two consecutive examinations of the right colon (upstream of the hepatic flexure) were made with WLI and LCI by the same operator. First-pass examination by WLI or LCI was randomized 1:1 after cecal intubation. According to statistical calculations, 10 endoscopy units had to include approximately 700 patients. The primary outcome was proximal adenoma miss rate. Secondary outcomes were the proximal miss rates for sessile serrated lesions (SSL), advanced adenomas, and polyps., Results: 764 patients were included from 1 January 2020 to 22 December 2022, and 686 patients were randomized (345 WLI first vs. 341 LCI first). Both groups were comparable in terms of demographics and indications. The proximal adenoma miss rate was not significantly higher in the WLI-first group (36.7%) vs. the LCI-first group (31.8%) (estimated mean absolute difference: 4.9% [95%CI -5.2% to 15.0%], P = 0.34). There was also no significant difference in miss rates for SSLs, advanced adenomas, and polyps in the proximal colon., Conclusions: In contrast to previous data, this study does not support the benefit of LCI to the proximal adenoma miss rate in routine colonoscopy., Competing Interests: David Karsenti, MD: consultant for Olympus, Coviden, and Norgine; support for attending meetings from Alfasigma, Cook, and Fujifilm. Guillaume Perrod, MD-PhD: consultant for Fujifilm. Lucille Quénéhervé, MD, PhD: support for attending meetings from Vifor Pharma. Edouard Chabrun, MD-PhD: honoraria for lectures and presentations from Norgine. Gabriel Rahmi, MD-PhD: consultant for Fujifilm, Medtronic, and Boston Scientific; support for attending meetings from Provepharm. Geoffroy Vanbiervliet, MD-PhD: consultant for Boston Scientific and Ambu; honoraria for lectures, presentations, and speeches from Pentax, Fujifilm, Tillots, and Norgine. Maryan Cavicchi, MD-PhD: consultant for Janssen-Cilag, AbbVie, and MSD; honoraria for lectures, presentations, and speeches from MSD France, Amgen, Galapagos, Takeda, Pfizer, Mylan, and Tillots; support for attending meetings from Ferring, Takeda, and MSD; board for Janssen-Cilag, AbbVie, Lilly, and Pfizer; receipt of equipment and materials from Celtrion and Biosynex. Xavier Dray, MD-PhD: co-founder and shareholder of Augmented Endoscopy; consultant for Norgine and Provepharm; honoraria for lectures, presentations, and speeches from Alfasigma, Bouchara Recordati, Medtronic, Norgine, and Sandoz; honoraria for live endoscopy from Fujifilm. B. Perrot, S. Koch, G. Velut, and M. Moreno-Garcia declare that they have no conflict of interest., (Thieme. All rights reserved.)

Competing Interests: Enrique Pérez-Cuadrado-Robles holds a consultancy agreement with Boston Scientific. The remaining authors not have conflict of interest related to this manuscript.

Competing Interests: Enrique Pérez-Cuadrado-Robles is a consultant for Boston Scientific. The other authors have no conflict of interest relating to this article.

Competing Interests: The authors declare that they have no conflict of interest.

Competing Interests: The authors declare that they have no conflict of interest.

Competing Interests: The authors declare that they have no conflict of interest.

Competing Interests: The authors declare that they have no conflict of interest.

Competing Interests: None

Background: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are the first-line treatments for superficial esophageal squamous cell carcinoma (SCC). This study aimed to compare long-term clinical outcome and oncological clearance between EMR and ESD for the treatment of superficial esophageal SCC., Methods: We conducted a retrospective multicenter study in five French tertiary care hospitals. Patients treated by EMR or ESD for histologically proven superficial esophageal SCC were included consecutively., Results: Resection was performed for 148 tumors (80 EMR, 68 ESD) in 132 patients. The curative resection rate was 21.3 % in the EMR group and 73.5 % in the ESD group ( P  < 0.001). The recurrence rate was 23.7 % in the EMR group and 2.9 % in the ESD group ( P  = 0.002). The 5-year recurrence-free survival rate was 73.4 % in the EMR group and 95.2 % in the ESD group ( P  = 0.002). Independent factors for cancer recurrence were resection by EMR (hazard ratio [HR] 16.89, P  = 0.01), tumor infiltration depth ≥ m3 (HR 3.28, P  = 0.02), no complementary treatment by chemoradiotherapy (HR 7.04, P  = 0.04), and no curative resection (HR 11.75, P  = 0.01). Risk of metastasis strongly increased in patients with tumor infiltration depth ≥ m3, and without complementary chemoradiotherapy ( P  = 0.02)., Conclusion: Endoscopic resection of superficial esophageal SCC was safe and efficient. Because it was associated with an increased recurrence-free survival rate, ESD should be preferred over EMR. For tumors with infiltration depths ≥ m3, chemoradiotherapy reduced the risk of nodal or distal metastasis., Competing Interests: None, (© Georg Thieme Verlag KG Stuttgart · New York.)