Prioritizing lymphadenectomy and specific surgical approaches improves outcomes in patients with adenocarcinoma of the esophagogastric junction.

• In a study of 2,044 patients, neoadjuvant therapy lowered lymph node metastasis rates overall.
• Total gastrectomy resulted in fewer complications (14.8%) compared to proximal gastrectomy (21.0%; p=0.001).

Laparoscopic approaches facilitated faster recovery without increasing complications (16.5% vs 17.3%).

• High lymph node metastasis was found primarily in abdominal stations, underscoring the need for thorough abdominal lymphadenectomy.