The CROSS trial compared neoadjuvant chemoradiotherapy followed by surgery with surgery alone in patients with oesophageal or gastro-oesophageal junction cancer. The landmark study established an important role for preoperative combined-modality treatment in resectable disease. Long-term follow-up showed that the survival advantage associated with the neoadjuvant chemoradiotherapy strategy persisted over a decade. The benefit was not limited to pathological response; it translated into better overall survival across the study population. For surgeons, CROSS reinforces the principle that the operative result should be interpreted within the full oncological pathway. Preoperative treatment can downstage disease, improve local control and address systemic risk before a major operation. At the same time, patient selection, nutritional status and fitness for oesophagectomy remain critical because multimodality treatment can be demanding. The trial has had a lasting impact on oesophageal cancer management and remains highly relevant to multidisciplinary teams. It illustrates how surgery can be strengthened—not replaced—by integrating radiation and systemic therapy before resection. For HCPs, the key lesson is to plan oesophageal cancer care as a coordinated pathway from staging through neoadjuvant treatment, surgery and long-term surveillance.