Definitive chemoradiotherapy (DCRT) yields poor overall and progression-free survival for patients with adenocarcinoma of the esophagus or esophago-gastric junction, underscoring the need for careful patient selection and treatment strategy refinement.

• Median overall survival (OS) was 19.6 months, with a 3-year OS of only 28%.
• The 90-day mortality rate was notable at 7.1%.
• Factors such as clinical T3-T4 category, lymph node involvement, and WHO performance status were associated with worse survival.

Surgeons should focus on thorough pre-treatment evaluation to inform patient discussions and enhance decision-making about DCRT’s use in this population.