Background/Objectives: Esophageal cancer (EC) represents a major global contributor to cancer-related mortality. The advent of artificial intelligence (AI), including machine learning, deep learning, and radiomics, holds promise for enhancing treatment decisions and predicting outcomes. The aim of this review is to present an overview of the current landscape and future perspectives of AI in the management of EC. Methods: A literature search was performed on MEDLINE using the following keywords: “Artificial Intelligence”, “Esophageal cancer”, “Barrett’s esophagus”, “Esophageal Adenocarcinoma”, and “Esophageal Squamous cell carcinoma”. All titles and abstracts were screened; the results included 41 studies. Results: Over the past five years, the number of studies focusing on the application of AI to the treatment and prognosis of EC has surged, leveraging increasingly larger datasets with external validation. The simultaneous incorporation in AI models of clinical factors and features from several imaging modalities displays improved predictive performance, which may enhance patient outcomes, based on direct personalized therapeutic options. However, clinicians and researchers must address existing limitations, conduct randomized controlled trials, and consider the ethical and legal aspects that arise to establish AI as a standard decision-support tool. Conclusions: AI applications may result in substantial advances in EC management, heralding a new era. Considering the complexity of EC as a clinical entity, the evolving potential of AI is anticipated to ameliorate patients’ quality of life and survival rates.

Background/Objectives: Anastomotic leakage is one of the most frightening and potentially fatal complications after esophagectomy. The collaboration between the surgical team, interventional gastroenterologists, and radiologists has the potential to improve the hospital stay, as well as morbidity and mortality. The aim of this study is to present our experience and evaluate the results of the multimodal management of anastomotic leak following esophagectomy in our unit. Methods: This is a retrospective study analyzing a single referral center’s prospectively maintained database of all patients diagnosed with anastomotic leak between March 2019 and March 2025 using the definition of the Esophageal Complications Consensus Group. The treatment pathways and the patient outcomes are presented. The primary endpoint was 90-day mortality and in-hospital mortality. Results: A total of 241 esophageal resections were performed between March 2019 and March 2025. Lymphadenectomy of the mediastinum was performed in 88.4% of the patients. Cervical and intrathoracic anastomosis were performed in 143 (59.3%) and 98 (40.7%) cases, respectively. Twenty-nine patients (12%) with a mean age of 59.1 years developed anastomotic leak. Anastomotic leak occurred in 14.3% of intrathoracic anastomoses and 10.5% of cervical anastomoses. The median day of leak diagnosis was the sixth postoperative day. Leak management involved conservative strategies, wound exploration, endoscopic stent placement or vacuum therapy, drainage of effusions under radiologic guidance, and reoperation. The 90-day and in-hospital mortality rate was 3.4%. No cases of conduit necrosis or mediastinitis were reported. Endoscopic management was employed in 18 patients (62.1%) as a first- or second-line treatment, while reoperation was required in 6 patients (20.7%). The median interval from diagnosis to anastomosis healing was 21 days and the median duration of hospital stay 32 days. The management was successful in 27 patients (93.1%) except for 1 who developed tracheoesophageal fistula and 1 who died due to hemorrhagic complication of anticoagulant treatment. Conclusions: Anastomotic leak after esophagectomy is considered a complex, diversified, and morbid clinical entity. The evolving potential of multidisciplinary management encompassing surgical and interventional radiological and endoscopic treatment addresses the mortality rates and heralds a new era of minimizing morbidity.

Gastric cancer is a significant global contributor to cancer-related mortality. Stage IV gastric cancer represents a significant percentage of patients in Western countries, with peritoneal dissemination being the most prevalent site. Peritoneal disease comprises two distinct entities, macroscopic (P1) and microscopic (P0CY1), which are associated with poor long-term survival rates. Although the present standard of treatment is palliative chemotherapy, a global controversy has arisen concerning specific patients with limited disease burden or conversion to negative lavage cytology following chemotherapy. Available approaches include systemic or intraperitoneal chemotherapy, upfront gastrectomy, and conversion surgery. This review consolidated the current evidence regarding multimodal management, indicating prolonged survival for this distinct subgroup of patients. Considering the complexity of peritoneal metastases, the potential of the multimodal approach unveils promising prospects for identifying the optimal treatment for this particular subset of stage IV patients and thus enhancing their survival outcomes.

Juvenile polyposis syndrome is a condition distinguished by numerous hyperproliferative polyps that can affect the entire gastrointestinal tract, though they are uncommon in the stomach. We report a rare case of a 70-year-old woman with a three-year history of epigastric pain and severe bloating who was referred to our department for gastric outlet obstruction due to massive gastric juvenile polyps also causing gastroparesis. The patient was successfully treated with a total gastrectomy.