{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T01:32:26Z","timestamp":1787621546774,"version":"build-2736575974"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Esophageal cancer (EC) remains a leading cause of cancer-related mortality worldwide. For patients with locally advanced, non-metastatic EC, advances in perioperative care, and surgical techniques have led to improved outcomes; however, significant variation persists, and standardization remains limited. This study aimed to characterize current practice patterns among expert surgeons at high-volume European centers through a structured, in-depth survey. Eight expert upper gastrointestinal surgeons from European centers performing &amp;gt;60 esophagectomies annually participated in comprehensive interviews. Topics included preoperative care pathways for distal esophageal\/gastroesophageal junction adenocarcinoma, technical aspects of Ivor Lewis esophagectomy, and postoperative recovery protocols. Additional focus areas included multidisciplinary team involvement, allied health integration, research program participation, and follow-up strategies. Widespread agreement (7\u20138 of 8 centers) was observed in several domains: national EC care regionalization, multidisciplinary cancer conference review of all patients, institutional EC research programs, use of prospective national\/international databases, application of CROSS chemoradiotherapy for squamous cell carcinoma, and perioperative FLOT chemotherapy for adenocarcinoma. Common surgical techniques included minimally invasive Ivor Lewis esophagectomy, two-field lymphadenectomy with en-bloc thoracic duct ligation, nasogastric tube placement, omental wrap of the anastomosis, and Enhanced Recovery After Surgery\u2013based postoperative protocols. The majority of centers (5\u20136\/8) performed routine preoperative optimization (nutrition, smoking cessation, frailty screening, oral hygiene\/microbiome assessment), jejunostomy placement, and postoperative contrast swallow studies. Areas with notable variability (\u22644\/8 centers) included intraoperative crural closure, pyloric drainage procedures, gastric conduit sizing, postoperative pain management, and follow-up imaging timelines. High-volume European centers demonstrated strong alignment in several programmatic and perioperative elements of EC care, particularly around enhanced recovery pathways and preoperative optimization. Nonetheless, key intraoperative and postoperative variations persist, highlighting opportunities for future research, consensus building, and standardization to improve patient outcomes.<\/jats:p>","DOI":"10.1093\/dote\/doaf100","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T14:29:02Z","timestamp":1763044142000},"source":"Crossref","is-referenced-by-count":1,"title":["Toward standardization in esophageal cancer surgery: patterns of practice across high-volume European centers"],"prefix":"10.1093","volume":"38","author":[{"given":"Daniel G","family":"Jones","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery, The Ottawa Hospital, University of Ottawa , Ottawa, ON ,","place":["Canada"]},{"name":"Ottawa Hospital Research Institute, University of Ottawa , Ottawa, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1859-9213","authenticated-orcid":false,"given":"Peter","family":"Grimminger","sequence":"additional","affiliation":[{"name":"Department of General and Abdominal Surgery, Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t Mainz , Mainz ,","place":["Germany"]},{"name":"Department of General, Visceral and Transplantation Surgery, Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t Mainz , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Clinical Surgery, St. James\u2019s Hospital, Trinity College Dublin , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Rosati","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, San Raffaele Hospital, Vita-Salute San Raffaele University , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Hanna","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London , London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6215-8132","authenticated-orcid":false,"given":"Magnus","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Division of Surgery and Oncology, Karolinska Institute , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8650-2017","authenticated-orcid":false,"given":"Sheraz","family":"Markar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oxford University , Oxford ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7134-261X","authenticated-orcid":false,"given":"Richard","family":"van Hillegersberg","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, University Medical Center Utrecht , Utretch ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8689-3134","authenticated-orcid":false,"given":"Mark","family":"van Berge Henegouwen","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Center, University of Amsterdam ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Gisbertz","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Center, University of Amsterdam ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Ferri","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Thoracic and Upper Gastrointestinal Surgery, McGill University , Montreal, QC ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J E","family":"Seely","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery, The Ottawa Hospital, University of Ottawa , Ottawa, ON ,","place":["Canada"]},{"name":"Ottawa Hospital Research Institute, University of Ottawa , Ottawa, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"2025111309285564200_ref1","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/S2468-1253(20)30007-8","article-title":"The global, regional, and national burden of oesophageal 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