Multidisciplinary Treatment for Esophagogastric Junction Cancer From a Dutch Perspective

Esophagogastric junction (EGJ) cancer is an increasing health burden worldwide. Over the past decade, significant advancements in centralization, multimodal treatment strategies, as well as the widespread adoption of minimally invasive surgical techniques, have led to marked improvements in perioperative outcomes and overall survival of EGJ cancer in the Netherlands. Perioperative treatment strategies have evolved toward intensified systemic therapy, with perioperative chemotherapy, particularly the FLOT regimen. The preferred approach for surgical treatment of EGJ cancer remains debated, however, minimally invasive transthoracic techniques are increasingly adopted and have led to superior radicality and decreased morbidity. Centralization of care with specialized multidisciplinary teams has been consistently associated with improved surgical quality and survival in the Netherlands, as confirmed by the registry-based nationwide quality control.