ArticleAnnals of surgical oncology2025
Definition and Predictors of Early Recurrence in Neoadjuvantly Treated Esophageal and Gastroesophageal Adenocarcinoma: a Dual-Center Retrospective Cohort Study.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed.
- Comparison of 24 Versus 46-Hour 5-FU Infusion Durations in the Perioperative FLOT Therapy for Gastric Cancer.Medicina (Kaunas, Lithuania) · 2026Article
- Esophageal cancer recurrence after multimodality therapy: analysis of patterns and implications on long-term survival.Journal of thoracic disease · 2026Article
- Predicting the Unpredictable: Prognostic Role of Systemic Inflammatory Indices and Tumor Biology of Neoadjuvant Chemotherapy Response in Gastric and Gastroesophageal Junction Cancer-Insights from a Systematic Review and Real-World Experience.Journal of clinical medicine · 2026Article
- Prognostic value of initial recurrence pattern for post-recurrence survival in locally advanced rectal cancer after neoadjuvant chemoradiotherapy and surgery.Frontiers in oncology · 2026Article
- Sentinel Lymph Node Mapping in Esophageal Cancer: Current Status and Future Directions.Annals of surgical oncology · 2025Review
- A pilot study of tegafur-uracil maintenance on survival in patients with esophageal squamous cell carcinoma following definitive chemoradiotherapy.Scientific reports · 2025Article
- ASO Author Reflections: Early Recurrence After Esophageal Cancer Resection Cannot be Predicted Preoperatively: A Call for More Reliable Biomarkers.Annals of surgical oncology · 2025Article
- Prognostic Nutritional Index Predicts Early Recurrence After Esophagectomy for Esophageal Cancer Following Neoadjuvant Chemotherapy.Cancer diagnosis & prognosisArticle
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12 authors.
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Abstract
abstarct
backgroundEarly recurrence after esophagectomy is often used as a surrogate for aggressive tumor biology and treatment failure. However, there is no standardized definition of early recurrence, and predictors for early recurrence are unknown. Therefore, we aimed to define an evidence-based cutoff to discriminate early and late recurrence and assess the influence of neoadjuvant treatment modalities for patients with esophageal or gastroesophageal-junction adenocarcinoma (EAC). PATIENTS AND
methodsThis dual-center retrospective cohort study included patients who underwent esophagectomy for stage II-III EAC after neoadjuvant treatment with chemotherapy using 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) or radiochemotherapy according to the Chemoradiotherapy for Esophageal Cancer followed by Surgery Study (CROSS) protocol from 2012 to 2022. The optimal cutoff for early versus late recurrence was calculated by using the most significant difference in survival after recurrence (SAR). Multivariable logistic regression was used to identify variables associated with early recurrence.
resultsOf 334 included patients, 160 (47.9%) were diagnosed with recurrence. Most patients had systemic (60.5%) or multiple sites of recurrence (21.1%), whereas local-only recurrence (9.2%) and carcinomatosis (9.2%) were rare. The optimal interval between surgery and recurrence for distinguishing early and late recurrence was 18 months (median SAR: 9.1 versus 17.8 months, p = 0.039) with only 24% of recurrences diagnosed after the calculated cutoff. Advanced pathologic tumor infiltration (ypT3-4, p = 0.006), nodal positivity (p = 0.013), poor treatment response (>10% residual tumor, p = 0.015), and no adjuvant treatment (p = 0.048) predicted early recurrence.
conclusionEarly recurrence can be defined as recurrent disease within 18 months. Hallmarks for early recurrence are poor response to neoadjuvant therapy with persisting advanced disease. In those patients, adjuvant therapy and closer follow-up should be considered.
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