Endoscopic resection and surgical resection are the two major therapeutic methods for early esophageal cancer. Endoscopic resection is safe and minimally invasive, but lymph node dissection can not be performed. Although surgery provides a rather thorough resection of the lesions and affected lymph nodes, surgical trauma brings certain negative impact on patients' long-term life quality. A comprehensive assessment of the patient's general condition, the risk of diseased lymph node metastasis, and the risk of the treatment itself is an important measure to optimize treatment decisions and formulate personalized treatment plans.