Introduction: Glomus tumor (GT) is a rare mesenchymal neoplasm that can be found anywhere throughout the body, including the stomach. Our goal was to present a case and a systematic review of the literature, reporting clinical, radiological, surgical, and pathological features of the disease. Methods: We reviewed Pubmed and SCOPUS for all case reports and case series published after 2000. Papers written in languages different from English and letters to the editor were excluded. Screening and data extraction were performed following the PRISMA guidelines. Results: A total of 89 studies were included in the systematic review, consisting of 187 cases of gastric glomus tumor. Mean age was 52 (18–90); most patients were female (61%). The most common clinical presentation was epigastric pain (33.9% of cases). The gastric antrum was the most frequently involved site (75.3%). Mean tumor size was 2.82 cm (0.8–17). Preoperative diagnosis was achieved in 22 cases, mostly by endoscopic ultrasound (EUS)-guided biopsy. Wedge resection was performed in 62% of treated patients. Smooth muscle actin was expressed in all cases with available immunohistochemistry. Malignant GT was reported in 11 cases. Discussion: Epigastric pain and bleeding were the most common symptoms at presentation in patients with diagnosis of glomus tumor. EUS-guided fine needle aspiration can be useful for preoperative diagnosis. Endoscopic elastosonography is a promising tool for the differential diagnosis of gastric submucosal lesions, including glomus tumors. The treatment of choice is wedge resection with adequate free margins. A laparoscopic approach is warranted when technically feasible. Since malignant gastric GTs have been described, long-term follow-up is suggested after surgical excision.

Pathological complete response (pCR) after neoadjuvant therapy is an established prognostic marker in several tumor types, but its significance in gastroesophageal adenocarcinoma (GEA) remains unclear. We investigated the role of pCR as a prognostic factor and as a predictive biomarker for benefit from adjuvant chemotherapy in a large real-world cohort of operable GEA. We retrospectively analyzed data from 532 patients with histologically confirmed esophageal, gastroesophageal junction, and gastric adenocarcinoma treated with neoadjuvant therapy followed by curative surgery (2012-2024) at two European high-volume centers. Tumor regression was assessed using the Becker classification. Overall survival (OS) and disease-free survival (DFS) were analyzed with Cox regression models and stratified by treatment regimen, tumor site, and pathologically documented response (pathological response; PR). pCR was observed in 13% of patients and was significantly associated with improved OS [hazard ratio (HR) 0.23, 95% confidence interval (CI) 0.13-0.40] and DFS (HR 0.29, 95% CI 0.17-0.47, both P < 0.001) in univariable analysis. In multivariable analysis, pCR remained an independent predictor of OS (HR 0.55, 95% CI 0.33-0.92, P = 0.023) and DFS (HR 0.53, 95% CI 0.32-0.89, P = 0.017) after adjustment for clinicopathological variables. Five-year OS and DFS were more than doubled in patients with pCR versus those without pCR (79% versus 39% and 73% versus 39%, respectively). No survival benefit from adjuvant chemotherapy was observed among patients with pCR. In contrast, those with partial or poor PR (Becker tumor regression grade 1b-3) derived significant benefit from post-operative chemotherapy for both OS and DFS (P < 0.001). pCR after neoadjuvant therapy is a robust, independent prognostic marker in GEA and is associated with more than double long-term survival compared with nonresponders. While adjuvant chemotherapy does not appear to improve outcomes in patients achieving pCR, it remains beneficial in those with incomplete/partial or absent PR after neoadjuvant chemotherapy. These findings support a response-adapted approach to perioperative treatment strategies in GEA.

Esophageal cancer is a highly lethal malignancy, representing 5% of all cancer-related deaths. The two main subtypes are esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). While most research has focused on ESCC, few studies have analyzed EAC for transcriptional signatures linked to diagnosis or prognosis. In this study, we utilized single-cell RNA sequencing and bulk RNA sequencing to identify specific immune cell types that contribute to anti-tumor responses, as well as differentially expressed genes (DEGs). We have characterized transcriptional signatures, validated against a wide cohort of TCGA patients, that are capable of predicting clinical outcomes and the prognosis of EAC post-surgery with efficacy comparable to the currently accepted prognostic factors. In conclusion, our findings provide insights into the immune landscape and therapeutic targets of EAC, proposing novel immunological biomarkers for predicting prognosis, aiding in patient stratification for post-surgical outcomes, follow-up, and personalized adjuvant therapy decisions.

Esophageal cancer is an extremely deadly tumor that accounts for 5% of all cancer deaths. The two main subtypes of the disease are esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). To date, few studies analyse EAC for transcriptional signatures associated with diagnosis and/or prognosis, while most focus on the analysis of transcriptional profiles of ESCC. In this study, we used single-cell RNA sequencing (scRNA-seq) analysis of CD45+ cells enriched from Tumors and matched Non Tumor tissues from therapy naїve patients to identify all types of immune cells present in tumor immune infiltrate and its transcriptional profile. In addi-tion, we analysed the entire transcriptome in a cohort of 23 patients whose tissue biopsies were taken from Tumors and matched with Non Tumor tissue. The transcriptional signatures we obtained were then used to stratify a large cohort of TCGA EAC patients, demonstrating a strong association with their prognosis, as well as the ability to predict a patient's clinical outcome and better define the prognosis of EAC after surgery. In addition, these features may lead patients to effective therapies including immunotherapy approaches.

The implementation of minimally invasive esophagectomy has gained widespread acceptance following the publication of randomized controlled trials demonstrating reduced pulmonary complications and shorter hospital stays. However, variability in reported anastomotic leak rates and differences in selected trial endpoints have raised questions regarding how best to balance innovation with patient safety during the adoption of new surgical techniques. This Lessons Learned article reflects on the ethical and clinical considerations surrounding the transition toward fully minimally invasive esophagectomy when excellent outcomes have been achieved with hybrid or open approaches in high-volume centers. Drawing on our institutional experience with a modified hybrid Ivor-Lewis technique, combining thoracoscopic lymphadenectomy with open reconstruction, we discuss how stepwise integration of minimally invasive surgical steps may preserve key postoperative outcomes during the learning curve. We argue that institutional performance and outcomes with major clinical impact, particularly anastomotic integrity and major complications, should play a central role in guiding the pace and modality of innovation adoption. Surgical progress should be driven by real-world results and structured learning pathways, ensuring that advances in esophageal surgery remain patient-centered and ethically sound.