Adenocarcinoma of the esophagogastric junction

Esophagogastric junction (EGJ) cancer is, among solid cancers, the fastest growing tumor in terms of incidence in Western countries, and due to the lifestyle changes in developing and newly industrialized countries, this trend is expected to intensify worldwide. EGJ adenocarcinoma, however, is poorly defined: first because it is not an “organ disease” but a “zone disease,” and also because among EGJ cancers there can be included different diseases with different etiology and different biology. Eastern countries, led by Japan, taught us the correct management of gastric cancer and provided us guide- lines for the treatment of esophageal squamous cell carcinoma. However when we talk about EGJ adenocarcinoma, it is a separate entity and is more properly a Western reality; therefore, Western countries should systematize and give answers to the relevant issues this cancer raises, along the road to standardization. Europe has been leading the evolution of thought on EGJ carcinoma, especially thanks to Siewert and the German school, which cre- ated the classification that still is used as a guide by clinicians in therapeutic strategy planning. With the introduction of the latest version of the TNM, all EGJ cancers were defined as esophageal cancers, suggesting the possibility of a uniform treatment. In the era of tailored treatment and targeted therapy, we may wonder if what we already have is enough or if we need to go further on, especially considering the lack of homogeneity in the choice of multi- modal treatments according only to topography. I then decided that it was still necessary to concentrate just on this difficult cancer and, together with my co-workers Simone Giacopuzzi and Andrea Zanoni, I decided to write a book, which we hope will shed a little light on such a complex and current topic. To make this book more international, I invited to participate, in order to give their significant key to interpretation, also some surgeons of renowned importance in the field. I would like to thank them all deeply for their contributions. Based on the experience of the Italian Research Group for Gastric Cancer (GIRCG) and the European Chapter of IGCA, we hope that this collaboration will start to build an even closer international cooperation with the opportu- nity to create a European network on EGJ adenocarcinoma.