{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:08:36Z","timestamp":1789668516170,"version":"4.0.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perioperative therapies for gastric and gastroesophageal junction (GEJ) adenocarcinoma have improved significantly in recent years, especially for mismatch-repair deficient (dMMR\/MSI-H) tumors. Pathologic complete response (pCR) rates are now established which has raised the question as to whether surgery can be omitted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This article summarizes the debate between two gastric cancer experts supporting each side of the argument on the possibility of omitting surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Total, proximal, and esophagogastrectomy remain highly morbid procedures that still carry significant risk of mortality, particularly in older patients and at low-volume centers. Patients with dMMR\/MSI-H gastric and GEJ adenocarcinoma have a pCR rate to neoadjuvant immunotherapy of 60% and those with mismatch repair intact (MMR-intact) tumors experience pCR to neoadjuvant chemo-immunotherapy with a rate of approximately 20%. The ability to assess for clinical complete response in gastric and GEJ adenocarcinoma has limitations, however, and there is a lack of long-term data to support omission of surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>pCR rates are established and durable in gastric and GEJ adenocarcinoma. Omission of surgery is a consideration in patients with dMMR\/MSI-H tumors with cCR to immunotherapy. Surgery remains the standard-of-care for patients with MMR-intact tumors but patients should be counseled about the possibility of pCR in shared decision making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-026-20293-0","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T22:36:01Z","timestamp":1785018961000},"page":"9249-9256","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Great Debate: Should Surgery Be Omitted in the Management of Gastroesophageal Junction Cancers?"],"prefix":"10.1245","volume":"33","author":[{"given":"Meredith A.","family":"Gunder","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian D.","family":"Badgwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn J.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"issue":"25","key":"20293_CR1","doi-asserted-by":"publisher","first-page":"2363","DOI":"10.1056\/NEJMoa2201445","volume":"386","author":"A Cercek","year":"2022","unstructured":"Cercek A, Lumish M, Sinopoli J, et al. 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