Diagnostic and therapeutic appropriateness in different stages of esophageal/GEJ cancers. The FICOG project

Background: Esophageal cancer is a rare neoplasm, with more than 0.6 million new cases and 0.54 million deaths worldwide in 2020. The distal third of the esophagus and the gastroesophageal junction (GEJ) are mostly involved sites. The diagnosis and therapeutic management of early, locally advanced, and metastatic disease continue to present uncertainties, as existing guidelines may not fully address all clinical questions in these areas. Methods: A group of Italian Experts produced recommendations for early, locally advanced, and metastatic disease management using the RAND/UCLA Appropriateness Method. Statements were generated by a systematic revision of the literature and voted on twice by a panel of 29 expert physicians; the second vote took place during a meeting of the panelists. Results: Several topics covered diagnosis, staging, treatment, and early, localized, and metastatic disease management. Recommendations were stated. Conclusions: Interventions considered appropriate to improve compliance and outcomes of esophageal/GEJ cancer patients were identified.