Treatment strategies for postoperative locoregional recurrent esophageal squamous cell carcinoma after curative resection: a narrative review
- 1Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574 Japan
Abstract
Recurrence following curative esophagectomy remains a major clinical challenge and is associated with poor prognosis. Treatment strategies for postoperative recurrent esophageal squamous cell carcinoma must be individualized based on recurrence patterns, prior treatment history, and patient-related factors. Locoregional recurrence and oligo-recurrence in some non-regional lymph nodes may still be amenable to curative-intent therapy, including salvage surgery and definitive chemoradiotherapy (CRT). Selection of optimal treatment should consider tumor burden, performance status, and prior radiation exposure. Salvage surgery offers favorable long-term outcomes in carefully selected patients, particularly when recurrence occurs in non-dissected regions. CRT remains a central treatment strategy for unresectable disease, whereas re-irradiation after prior radiotherapy carries a substantial risk of severe toxicity and requires cautious patient selection. Advances in radiotherapy techniques, including intensity-modulated radiotherapy and particle therapy, may improve therapeutic efficacy while reducing toxicity. In parallel, systemic therapies, particularly immune checkpoint inhibitors, have expanded treatment options; however, their role in locoregional recurrence remains to be fully defined. Importantly, prognostic factors should not only be considered descriptive variables but also integrated into clinical decision-making to distinguish candidates for curative versus palliative treatment. Future strategies integrating precision oncology and multimodal approaches are expected to further improve outcomes. Prospective studies are needed to establish optimal treatment algorithms.
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BibTeX
@article{jingu2026treatment,
title = {{Treatment strategies for postoperative locoregional recurrent esophageal squamous cell carcinoma after curative resection: a narrative review}},
author = {Keiichi Jingu and Rei Umezawa and Takaya Yamamoto and Noriyoshi Takahashi and Ken Harada and Yu Suzuki and Keita Kishida and So Omata and Hinako Harada and Nanae Chiba and Shinsaku Okuda and Sota Uchimi and Masato Hirano and Yushi Takahashi and Kouki Mori},
journal = {Esophagus},
year = {2026},
month = jul,
doi = {10.1007/s10388-026-01234-y},
url = {https://doi.org/10.1007/s10388-026-01234-y},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Treatment strategies for postoperative locoregional recurrent esophageal squamous cell carcinoma after curative resection: a narrative review
AU - Keiichi Jingu
AU - Rei Umezawa
AU - Takaya Yamamoto
AU - Noriyoshi Takahashi
AU - Ken Harada
AU - Yu Suzuki
AU - Keita Kishida
AU - So Omata
AU - Hinako Harada
AU - Nanae Chiba
AU - Shinsaku Okuda
AU - Sota Uchimi
AU - Masato Hirano
AU - Yushi Takahashi
AU - Kouki Mori
PY - 2026
DA - 2026/07/20
JO - Esophagus
DO - 10.1007/s10388-026-01234-y
UR - https://doi.org/10.1007/s10388-026-01234-y
AB - Recurrence following curative esophagectomy remains a major clinical challenge and is associated with poor prognosis. Treatment strategies for postoperative recurrent esophageal squamous cell carcinoma must be individualized based on recurrence patterns, prior treatment history, and patient-related factors. Locoregional recurrence and oligo-recurrence in some non-regional lymph nodes may still be amenable to curative-intent therapy, including salvage surgery and definitive chemoradiotherapy (CRT). Selection of optimal treatment should consider tumor burden, performance status, and prior radiation exposure. Salvage surgery offers favorable long-term outcomes in carefully selected patients, particularly when recurrence occurs in non-dissected regions. CRT remains a central treatment strategy for unresectable disease, whereas re-irradiation after prior radiotherapy carries a substantial risk of severe toxicity and requires cautious patient selection. Advances in radiotherapy techniques, including intensity-modulated radiotherapy and particle therapy, may improve therapeutic efficacy while reducing toxicity. In parallel, systemic therapies, particularly immune checkpoint inhibitors, have expanded treatment options; however, their role in locoregional recurrence remains to be fully defined. Importantly, prognostic factors should not only be considered descriptive variables but also integrated into clinical decision-making to distinguish candidates for curative versus palliative treatment. Future strategies integrating precision oncology and multimodal approaches are expected to further improve outcomes. Prospective studies are needed to establish optimal treatment algorithms.
SN - 1612-9059
SN - 1612-9067
ER -