Adenocarcinoma of the gastroesophageal junction: challenges in staging and treatment

Adenocarcinoma of the GEJ has seen a rapid increase in incidence over the last decades. Because of their borderline location between esophagus and stomach, the optimal management for these tumors is still an important subject for debate. Especially for the true cardiacarcinomas, i.e. type II tumors, there are still a lot of controversies regarding the optimal approach in neoadjuvant therapy and surgery. Although surgery is considered to be mandatory for curative treatment, postoperative complications are still a significant problem. Also, long-term survival in GEJ adenocarcinomas remains poor despite the increased use of multimodality treatments. The research presented in this thesis aims to evaluate current treatment strategies and to bring more insight in the optimal approach for GEJ adenocarcinomas. Secondly, important postoperative complications were evaluated. Also, prognostic factors for overall survival and recurrent disease were addressed.