Neoadjuvant chemotherapy (NCT) significantly improves long-term survival in patients with esophageal and esophagogastric junction adenocarcinoma compared to chemoradiotherapy (NCRT).

• Overall survival rates at 1, 3, and 5 years with NCT were 95.4%, 81.5%, and 73.8% versus 87.8%, 64.8%, and 56% for NCRT (p < 0.001).
• Disease-free survival also favored NCT, with a substantially reduced risk of death (HR 0.49, p < 0.001) and recurrence (HR 0.24, p < 0.001).

Consider the type of neoadjuvant therapy when discussing prognosis with patients.