Polkowski WP, et al. - Researchers tested their hypothesis that the proximal gastric resection (PGR) with an anti-reflux procedure may benefit even in advanced proximal gastric cancer (GC) after downstaging with the neo-adjuvant chemotherapy. To prevent reflux symptoms, they introduced a novel technique of end-to-side esophago-gastrostomy with the posterior wall of the gastric stump and partial neo-fundoplication. For this study, they selected 20 consecutive patients with the diagnosis of loco-regionally advanced GC, localized in the subcardiac region or proximal upper third of the stomach. Outcomes suggest that patients with advanced GC could undergo proximal gastrectomy safely after neo-adjuvant chemotherapy with acceptable survival. The postoperative reflux was reduced in correlation to performing posterior esophago-gastrostomy with partial neo-fundoplication, while an antireflux therapy could be effective for patients with persistent reflux symptoms.