Type II and III adenocarcinoma of the esophago-gastric junction: esophageal extent ≥1.5 cm critical for mediastinal nodal disease

In their seminal work on adenocarcinoma of the esophago-gastric junction, Mitchell et al. (1) rise the important question of mediastinal nodal involvement specifically in patients with Siewert II/III cancer following trimodality therapy. The standard surgical adenocarcinoma of the esophago-gastric junction. As for treatment strategies include esophagectomy for type I and gastrectomy for type III “true junctional cancers”, i.e., type II, it remains debatable whether the extension of resection in the oral or aboral direction represents the most effective surgical therapy (2).