Biological Characteristics and Therapeutic Strategies for Resectable Locally Advanced Esophagogastric Junction...

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Esophagogastric junction (EGJ) cancer definition and treatment vary globally.
• EGJ adenocarcinoma exhibits heterogeneous molecular profiles, necessitating EGJ-specific strategies.
• Existing international guidelines show significant regional disparities.

Purpose of the Study:

• To review recent advancements in the biological characteristics of EGJ cancers.
• To summarize updated management and treatment strategies for EGJ cancers.
• To address regional differences in EGJ cancer care.

Main Methods:

• Review of recent clinical trials (e.g., TIME, MIRO, MONET, REVATE, FLOT4, ESOPEC, RESOLVE, PRODIGY, KEYNOTE-585, MATTERHORN).
• Analysis of surgical approaches, including minimally invasive surgery (MIS) and robot-assisted surgery.
• Evaluation of perioperative chemotherapy regimens and immune checkpoint inhibitor efficacy.

Main Results:

• Minimally invasive surgery (MIS) improves postoperative outcomes and quality of life.
• MIS demonstrates non-inferiority to open surgery for long-term oncological results.
• Regional variations exist in recommended perioperative chemotherapy (e.g., FLOT vs. S-1 based) and immunotherapy use.

Conclusions:

• EGJ cancer requires tailored, region-specific management strategies.
• Advancements in surgical techniques and perioperative treatments are improving patient outcomes.
• Future research should focus on refining EGJ classification, molecular-guided therapies, organ preservation, and perioperative immunochemotherapy.