|A Japanese randomized controlled trial (JCOG9502) demonstrated no survival benefit of left transthoracic approach compared with transhiatal approach for patients with Siewert type II or III adenocarcinoma. Based on the results of this trial, transhiatal resection of the distal esophagus with lymph node dissection of the lower mediastinum is recommended when the length of esophageal invasion is within 3 cm. However, the optimal lymph node dissection for esophagogastric junction (EGJ) cancer is still unclear. In order to elucidate the overall characteristics of lymph node metastasis from EGJ cancer, the Japanese Gastric Cancer Association (JGCA) and the Japan Esophageal Society (JES) initiated a nationwide prospective study in 2014. This study will demonstrate the precise metastatic rates of lymph nodes in both histological types of EGJ cancer, and lead to the establishment of standard surgery for this disease.