Innovative Directions in Esophagogastric Cancer Care: from Single-center to Real-World Evidence

Innovative Directions in Esophagogastric Cancer Care: from Single-center to Real-World EvidenceEsophageal and gastric cancers remain among the most lethal solid tumors worldwide, despite major advances in surgical technique, perioperative care, and systemic therapies. Evidence from landmark trials and high-performing centers has shaped modern multimodal strategies—yet translating these pathways into routine practice is often limited by heterogeneous patient fitness, variable access to specialized teams, and differences in healthcare organization. Real-world data can complement trial evidence by clarifying how treatment sequencing, completion rates, postoperative outcomes, and toxicity profiles behave outside controlled settings. At the same time, increasing molecular stratification and the expansion of immunotherapy raise new questions about eligibility gaps, treatment targets, and outcomes across diverse populations. Bridging single-center innovation with population-level evidence is now essential to improve outcomes and equity in esophagogastric cancer care.This Research Topic will explore how innovations in esophagogastric cancer management perform when scaled from specialized programs to broader, real-life settings. We aim to highlight pragmatic evidence on perioperative and multimodal pathways, surgical quality and benchmarking, and the effectiveness and tolerability of combination therapies—including chemo(radio)therapy and immunotherapy—in routine clinical practice. Particular attention will be given to how multidisciplinary decision-making, timing, and sequencing influence treatment completion and oncologic outcomes across institutions and countries. We also welcome contributions connecting immunohistochemical and molecular profiles to real-world results in both curative-intent and advanced disease settings, including palliative approaches and quality-of-life outcomes. A strong international perspective—especially cross-country European comparisons—will be valued to identify transferable models of care, drivers of variability, and actionable strategies to improve access, centralization policies, and patient-centered outcomes.We welcome Original Research, Review, Mini Review, Perspective, and high-quality Methodology articles on themes including, but not limited to:- Perioperative and multimodal pathways: neoadjuvant → surgery → adjuvant completion rates; sequencing and timing; MDT decision patterns and variation across centers/countries- Surgical outcomes in real-world settings: open vs minimally invasive approaches; complication profiles, failure-to-rescue, readmissions; “textbook outcome”, benchmark metrics, and volume–outcome relationships- Combination therapy in routine practice: real-world effectiveness/toxicity; eligibility gaps vs trial populations; outcomes in older/frail and comorbidity-heavy cohorts- Advanced esophagogastric cancer care: IHC/molecular profiles and outcomes; therapeutic targets and achievements; palliative treatments and quality of life- Data sources and measurement: registries, administrative data, EHR-derived cohorts; endpoint definitions (recurrence, complications, PROs); pragmatic validation studies- Equity, access, and international comparisons: diagnostic/treatment delays; centralization and referral patterns; geographic and cross-country comparisons (especially Europe)Out of scope: manuscripts based solely on unvalidated analyses of public datasets without clinical or independent cohort validation, and purely technical computational studies without a clear, actionable clinical question or endpoint. Topic editors: Riccardo Rosati, Francesco Puccetti Source: https://www.frontiersin.org/research-topics/77555/innovative-directions-in-esophagogastric-cancer-care-from-single-center-to-real-world-evidence