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Gastroesophageal Cancer: Advances in Clinical Diagnosis and Management
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Gastroesophageal Cancer: Advances in Clinical Diagnosis and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 10 November 2025 | Viewed by 2126

Special Issue Editors

Dr. Tania Triantafyllou

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Guest Editor
First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, 11527 Athens, Greece
Interests: esophageal cancer; gastric cancer; personalized medicine; surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Maximos Frountzas

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Guest Editor
First Propaedeutic Department of Surgery, Hippocration General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: gastrointestinal cancer; gastric cancer surgery; esophageal cancer surgery; pancreatic cancer surgery; oncology; nutrition
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Gastroesophageal junction cancer is the eighth most common malignancy and the sixth most common cause of death secondary to cancer. Even though prognosis still largely depends on disease progression, recent breakthroughs have significantly improved associated outcomes. This Special Issue will focus on the advances of the diagnostics, endoscopic resections, perioperative therapies and minimally invasive and robotic techniques in the treatment of gastroesophageal malignancy. Esophagectomy presents high morbidity and mortality rates; however, a multimodal approach in the management of postoperative complications seems to offer good results, whereas minimally invasive approaches tend to improve part of the complications. The role of chemotherapy, chemoradiotherapy and immunotherapy in the curative and palliative setting of esophageal cancer will be discussed, whereas the therapeutic approach of the oligometastatic disease shall be presented.

Dr. Tania Triantafyllou
Dr. Maximos Frountzas
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastroesophageal cancer
  • endoscopic therapy
  • minimally invasive surgery
  • multimodality treatment
  • immunotherapy

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Published Papers (4 papers)

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Research

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12 pages, 328 KiB  
Article
Addressing Anastomotic Leak After Esophagectomy: Insights from a Specialized Unit
by Alexandra Triantafyllou, Evgenia Mela, Charalampos Theodoropoulos, Andreas Panagiotis Theodorou, Eleni Kitsou, Konstantinos Saliaris, Sofia Katsila, Konstantinos Kakounis, Tania Triantafyllou and Dimitrios Theodorou
J. Clin. Med. 2025, 14(11), 3694; https://doi.org/10.3390/jcm14113694 - 25 May 2025
Viewed by 231
Abstract
Background/Objectives: Anastomotic leakage is one of the most frightening and potentially fatal complications after esophagectomy. The collaboration between the surgical team, interventional gastroenterologists, and radiologists has the potential to improve the hospital stay, as well as morbidity and mortality. The aim of this [...] Read more.
Background/Objectives: Anastomotic leakage is one of the most frightening and potentially fatal complications after esophagectomy. The collaboration between the surgical team, interventional gastroenterologists, and radiologists has the potential to improve the hospital stay, as well as morbidity and mortality. The aim of this study is to present our experience and evaluate the results of the multimodal management of anastomotic leak following esophagectomy in our unit. Methods: This is a retrospective study analyzing a single referral center’s prospectively maintained database of all patients diagnosed with anastomotic leak between March 2019 and March 2025 using the definition of the Esophageal Complications Consensus Group. The treatment pathways and the patient outcomes are presented. The primary endpoint was 90-day mortality and in-hospital mortality. Results: A total of 241 esophageal resections were performed between March 2019 and March 2025. Lymphadenectomy of the mediastinum was performed in 88.4% of the patients. Cervical and intrathoracic anastomosis were performed in 143 (59.3%) and 98 (40.7%) cases, respectively. Twenty-nine patients (12%) with a mean age of 59.1 years developed anastomotic leak. Anastomotic leak occurred in 14.3% of intrathoracic anastomoses and 10.5% of cervical anastomoses. The median day of leak diagnosis was the sixth postoperative day. Leak management involved conservative strategies, wound exploration, endoscopic stent placement or vacuum therapy, drainage of effusions under radiologic guidance, and reoperation. The 90-day and in-hospital mortality rate was 3.4%. No cases of conduit necrosis or mediastinitis were reported. Endoscopic management was employed in 18 patients (62.1%) as a first- or second-line treatment, while reoperation was required in 6 patients (20.7%). The median interval from diagnosis to anastomosis healing was 21 days and the median duration of hospital stay 32 days. The management was successful in 27 patients (93.1%) except for 1 who developed tracheoesophageal fistula and 1 who died due to hemorrhagic complication of anticoagulant treatment. Conclusions: Anastomotic leak after esophagectomy is considered a complex, diversified, and morbid clinical entity. The evolving potential of multidisciplinary management encompassing surgical and interventional radiological and endoscopic treatment addresses the mortality rates and heralds a new era of minimizing morbidity. Full article
(This article belongs to the Special Issue Gastroesophageal Cancer: Advances in Clinical Diagnosis and Management)
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10 pages, 197 KiB  
Article
Post-Esophagectomy Dumping Syndrome: Assessing Quality of Life of Long-Term Survivors
by Dionysios Dellaportas, Ioannis Margaris, Eleftherios Tsalavoutas, Zoi Gkiafi, Anastasia Pikouli, Despoina Myoteri, Nikolaos Pararas, Panagis M Lykoudis, Constantinos Nastos and Emmanuel Pikoulis
J. Clin. Med. 2025, 14(10), 3587; https://doi.org/10.3390/jcm14103587 - 21 May 2025
Viewed by 125
Abstract
Background/Objectives: Survival rates for esophageal cancer patients have markedly improved. Inevitably, attention has been drawn to functional and quality-of-life problems. The aim of the current study was to investigate the prevalence of dumping syndrome in patients following esophageal resection and its correlation with [...] Read more.
Background/Objectives: Survival rates for esophageal cancer patients have markedly improved. Inevitably, attention has been drawn to functional and quality-of-life problems. The aim of the current study was to investigate the prevalence of dumping syndrome in patients following esophageal resection and its correlation with postoperative quality of life. Methods: This cross-sectional study involved disease-free patients who underwent a potentially curative resection for esophageal or gastroesophageal junction carcinoma between January 2019 and January 2024 in a single academic institution. Patients were asked to fill in two questionnaires: the Dumping Syndrome Rating Scale (DSRS) and the QLQ-OG25. A Composite Dumping Syndrome Index (CDSI) was calculated by adding the summary severity and frequency scores for each patient. Results: During the study period, 42 patients underwent esophagectomy for malignant esophageal or junctional tumors. In total, 14 eligible patients responded to the questionnaires at a mean time of 19.7 (±20.8) months following their operation. Three patients (21%) reported having at least quite severe problems related to at least two dumping symptoms. Six patients (43%) reported that they avoid certain foods in order to alleviate related problems. A high CDSI score was associated with significantly increased OG25 scores for dysphagia, eating restriction, odynophagia, pain and discomfort, and reflux (p < 0.05). Conclusions: Early dumping syndrome can occur in a significant proportion of patients following esophagectomy and may adversely affect quality of life. Full article
(This article belongs to the Special Issue Gastroesophageal Cancer: Advances in Clinical Diagnosis and Management)
21 pages, 8861 KiB  
Article
Oligometastatic Mixed Neuroendocrine Adenocarcinoma of the Esophago-Gastric Junction: A Case of Successful Multidisciplinary Management, the Lessons Learnt and Review of the Literature
by Anastasia Sotiropoulou, Maria Avgoustidou, Vassilis Milionis, Ioannis Papadimitriou, Chrysovalantis Vergadis, Dimitrios Schizas, Nikolaos Arkadopoulos and Orestis Lyros
J. Clin. Med. 2025, 14(5), 1503; https://doi.org/10.3390/jcm14051503 - 24 Feb 2025
Viewed by 486
Abstract
Background: Mixed neuroendocrine–non-neuroendocrine neoplasms (MiNENs) of the esophago-gastric junction (EGJ) are rare aggressive malignant neoplasms, with, currently, limited evidence regarding the appropriate therapeutic approach. Methods: Herein, we report multimodal treatment management of a patient with oligometastatic MiNEN of EGJ (Siewert III), discuss the [...] Read more.
Background: Mixed neuroendocrine–non-neuroendocrine neoplasms (MiNENs) of the esophago-gastric junction (EGJ) are rare aggressive malignant neoplasms, with, currently, limited evidence regarding the appropriate therapeutic approach. Methods: Herein, we report multimodal treatment management of a patient with oligometastatic MiNEN of EGJ (Siewert III), discuss the lessons learnt, and provide a review of the literature. Results: A 69-year-old female was diagnosed with a locally advanced EGJ tumor and three liver metastases (cT4, cN+, M1). Although the initial histology from biopsy revealed adenocarcinoma, the histopathology of a lymph node biopsy from staging laparoscopy revealed infiltration of neuroendocrine carcinoma cells. Thus, the diagnosis of a mixed neuroendocrine adenocarcinoma was set, and systemic chemotherapy with etoposide and cisplatin was initiated. A major clinical response led to conversion surgical resection of the primary tumor and metastases, followed by adjuvant therapy with immunotherapy. The patient is free of disease at the 3-year follow-up. A review of the literature on similar cases of EGJ or gastric MiNENs revealed a limited number of cases. Out of the 39 patients, 20 of them (51.3%) suffered from advanced-stage disease. The MiNEN diagnosis typically occurred after surgical resection. Systemic chemotherapy against the neuroendocrine component demonstrated significant response rates, while in cases in which conversion surgery was offered, prolongation of survival was demonstrated. Conclusions: Our case and the existing literature on MiNENs of EGJ underline the need for a personalized treatment approach following thorough interpretation of comprehensive pretherapeutic staging. Conversion radical surgery with curative intent could be considered in cases of major or complete clinical response to induction chemotherapy with potentially favorable outcomes. Full article
(This article belongs to the Special Issue Gastroesophageal Cancer: Advances in Clinical Diagnosis and Management)
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Review

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20 pages, 453 KiB  
Review
Current Role of Artificial Intelligence in the Management of Esophageal Cancer
by Evgenia Mela, Dimitrios Tsapralis, Dimitrios Papaconstantinou, Panagiotis Sakarellos, Chrysovalantis Vergadis, Michail E. Klontzas, Ioannis Rouvelas, Antonios Tzortzakakis and Dimitrios Schizas
J. Clin. Med. 2025, 14(6), 1845; https://doi.org/10.3390/jcm14061845 - 9 Mar 2025
Viewed by 912
Abstract
Background/Objectives: Esophageal cancer (EC) represents a major global contributor to cancer-related mortality. The advent of artificial intelligence (AI), including machine learning, deep learning, and radiomics, holds promise for enhancing treatment decisions and predicting outcomes. The aim of this review is to present [...] Read more.
Background/Objectives: Esophageal cancer (EC) represents a major global contributor to cancer-related mortality. The advent of artificial intelligence (AI), including machine learning, deep learning, and radiomics, holds promise for enhancing treatment decisions and predicting outcomes. The aim of this review is to present an overview of the current landscape and future perspectives of AI in the management of EC. Methods: A literature search was performed on MEDLINE using the following keywords: “Artificial Intelligence”, “Esophageal cancer”, “Barrett’s esophagus”, “Esophageal Adenocarcinoma”, and “Esophageal Squamous cell carcinoma”. All titles and abstracts were screened; the results included 41 studies. Results: Over the past five years, the number of studies focusing on the application of AI to the treatment and prognosis of EC has surged, leveraging increasingly larger datasets with external validation. The simultaneous incorporation in AI models of clinical factors and features from several imaging modalities displays improved predictive performance, which may enhance patient outcomes, based on direct personalized therapeutic options. However, clinicians and researchers must address existing limitations, conduct randomized controlled trials, and consider the ethical and legal aspects that arise to establish AI as a standard decision-support tool. Conclusions: AI applications may result in substantial advances in EC management, heralding a new era. Considering the complexity of EC as a clinical entity, the evolving potential of AI is anticipated to ameliorate patients’ quality of life and survival rates. Full article
(This article belongs to the Special Issue Gastroesophageal Cancer: Advances in Clinical Diagnosis and Management)
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