Abstract:
The 16th International Gastric Cancer Congress (IGCC 2025) highlighted advances in the treatment of esophagogastric junction cancer (EGJC). From a medical oncology perspective, the unique molecular subtypes of EGJC are critical for prognosis and therapeutic decision‑making. Key research topics include the optimal time to surgery after neoadjuvant therapy, active survei-llance strategies, comparisons between perioperative chemotherapy and neoadjuvant chemoradio-therapy, and the exploration of immunotherapy and targeted therapy. Recent studies, such as ESOPEC, demonstrated that perioperative chemotherapy with the FLOT regimen is superior to conventional chemoradiotherapy, while immunotherapy shows promise in improving pathological response and survival outcomes. From the surgical perspective, ongoing debates focus on redefining adenocarcinoma of esophagogastric junction (AEG) classification and optimizing surgical strategies, particularly regarding approaches and mediastinal lymphadenectomy for Siewert Ⅱ AEG. Results from the European TIGER study are eagerly awaited, and the CLASS‑10 trial led by our institution is expected to provide high‑level evidence to guide lymphadenectomy strategies in AEG. The authors provide an in‑depth introduction to the diagnosis and treatment strategies of EGJC from a multi-disciplinary perspective, highlighting the challenges posed by the uniqueness of EGJC to research and clinical practice. Future efforts should emphasize controlling heterogeneity and designing precise clinical trials based on molecular and anatomical classifications to promote individualized treatment strategies.