Defining disease recurrence after curative treatment of esophageal cancer: a literature review

BACKGROUND: Despite aggressive multimodal treatment, disease recurs in 30-40% of patients with esophageal cancer. In selected patients with isolated locoregional recurrence (LRR), radical treatment may lead to long-term survival. Lack of consensus on the definition of LRR complicates the selection of optimal treatment strategies. This study aimed to review the literature on the definition of LRR.

METHODS: A systematic search of Embase and Medline Ovid databases was conducted to identify studies reporting on LRR after curative treatment for advanced esophageal cancer. Data on the definition of LRR, the staging system used, and the treatment strategies were extracted and tabulated. The primary outcome was the definition of LRR by anatomical site and the staging system used. Secondary outcomes included treatment strategies and outcomes for LRR.

RESULTS: In total, 2856 studies on LRR after esophageal cancer treatment were identified, of which 44 were included and assessed. There was substantial variation in the anatomical location of LRR, with only six studies referring to TNM staging manuals for defining recurrence. Treatment and outcome for LRR were infrequently reported with considerable variation.

CONCLUSION: Definitions of LRR after curative treatment for esophageal cancer are inconsistent. Standardization of LRR is needed to improve comparability across studies and guide clinical management.