What is the optimal management of patients with gastroesophageal cancer who progress to metastatic disease during preoperative FLOT?

As we all know, peri-operative FLOT is considered a standard-of-care for locally advanced GEJ/gastric adenocarcinomas (at least the vast majority of tumors that are MMR proficient/MSS). In my experience, actual progression of a carefully staged locally advanced cancer to metastatic disease during preoperative FLOT is rare. An important exception occurs in patients who did not undergo a diagnostic laparoscopy at baseline and are then found to have small-volume disease at the time of planned surge...