Survival benefit of local treatment for oligo-recurrence after esophageal cancer surgery

TL;DR

Treating limited recurrence of esophageal cancer with local methods improves survival compared to chemotherapy alone.

Contribution

Demonstrates that local treatment for oligo-recurrence significantly improves survival in postoperative esophageal cancer patients.

Findings

Oligo-recurrence occurred in 40.4% of patients with postoperative esophageal cancer recurrence.

Local treatment for oligo-recurrence was associated with a significantly higher 2-year survival rate (80%) compared to non-local treatment (13%).

Local treatment remained independently associated with improved survival in multivariate analysis (HR: 0.31).

Abstract

Postoperative recurrence of esophageal cancer is generally associated with poor survival; however, oligo-recurrence, a limited pattern of recurrence, may influence long-term survival outcomes.

We retrospectively analyzed 57 patients who developed postoperative recurrence of thoracic esophageal cancer between April 2016 and March 2024. Oligo-recurrence was defined as recurrence involving three or fewer lesions confined to a single organ. Recurrence patterns, treatment strategies, and post-recurrence survival were evaluated.

The cohort included 48 men and 9 women, with a median age at recurrence of 72 years (range: 50–84 years). Oligo-recurrence occurred in 23 patients (40.4%); of these, 18 (78.3%) received local treatment (surgery or chemoradiotherapy), and 5 (21.7%) received chemotherapy alone. The 2-year post-recurrence survival rate was significantly higher in the oligo group than in the non-oligo group (50.8% vs. 3.7%, p < 0.05). Within the oligo group, 11 patients who achieved disease control with local treatment had a 2-year survival rate of 80%, compared with 13% in the remaining patients (p < 0.05). Univariate analysis identified early recurrence within 1 year (hazard ratio [HR]: 1.94; 95% confidence interval [CI]: 1.014–3.811; p < 0.05), oligo-recurrence (HR: 0.28; 95% CI: 0.143–0.555; p < 0.05), and local treatment (HR: 0.23; 95% CI: 0.107–0.525; p < 0.05) as significant factors. In multivariate analysis, only local treatment remained independently associated with improved survival (HR: 0.31; 95% CI: 0.087–0.998; p = 0.048).

Local treatment for oligo-recurrence is associated with improved survival outcomes in selected patients with recurrent esophageal cancer.

The online version contains supplementary material available at 10.1186/s12957-026-04212-x.

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