van Hootegem SJM, et al. - Researchers examined the association of signet ring cell (SRC) differentiation with survival and response to neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy (nCRT) in patients with esophageal and junctional adenocarcinoma (EAC). Overall, SRCs were noted in 129 (19%) of 689 included patients (nCT: n = 64; nCRT: n = 65). A more advanced ypT stage, a higher number of positive lymph nodes in the resection specimen and a higher rate of R1/R2 resections were reported in the SRC group. No independent correlation of SRC differentiation with worse overall survival (OS) was observed in EAC patients who underwent neoadjuvant therapy and surgery. However, greater tumor downstaging and better disease-free survival were noted in correlation with nCRT.