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Gastrointestinal cancer
Salvage Radiotherapy for Loco-regional Recurrence of Esophageal Cancer Following Surgery
Won Kyung Cho, Jae Myoung Noh, Dongryul Oh, Yong Chan Ahn, Jong-Mu Sun, Hong Kwan Kim, Young Mog Shim
Cancer Res Treat. 2025;57(1):165-173.   Published online July 26, 2024
DOI: https://doi.org/10.4143/crt.2024.191
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
There is few evidence regarding the optimal salvage treatment options for loco-reginal recurrence of esophageal cancer. This study aimed to evaluate the clinical outcomes of salvage radiotherapy (RT) in patients with loco-regional recurrence (LRR) after surgery for esophageal cancer.
Materials and Methods
We retrospectively reviewed 147 esophageal cancer patients who received salvage RT for loco-regional recurrence between 1996 and December 2019. A total dose of 60 Gy in 20 fractions was used for RT alone and 60-70 Gy in 30-35 fractions for concurrent chemoradiotherapy (CCRT).
Results
The patients’ median age was 65 years (range, 41 to 86 years). The median disease-free interval was 13.5 months (1.0 to 97.4 months). After a median 18.8 months follow-up, the 2-year overall survival (OS) and progression-free survival (PFS) rates were 38.1% and 25.9%, respectively. The median OS and PFS were 18.8 and 8.4 months, respectively. The CCRT could not improve OS compared to RT (p=0.336), but there was a trend of better PFS in the CCRT group. Regarding toxicities, the rate of grade 3 or higher toxicity was 10.9% occurring in 16 patients, and it was higher in patients who received CCRT than in the RT alone group (19.6% vs. 6.3%, p=0.023).
Conclusion
Salvage RT alone as well as CCRT could be effective in patients with locoregionally recurrent esophageal cancer.

Citations

Citations to this article as recorded by  
  • Review of Neoadjuvant Strategies in Esophageal Squamous Cell Carcinoma: JCOG1109 NExT is Here to Stay
    Mayank Tripathi, Kumar Vineet
    Indian Journal of Surgery.2026; 88(3): 700.     CrossRef
  • Essential Updates 2024–2025: Surgical Strategy for Esophageal Cancer Toward a New Paradigm in the Era of Immunotherapy and Personalization
    Shuichiro Oya, Koichi Yagi, Yoshifumi Baba
    Annals of Gastroenterological Surgery.2026;[Epub]     CrossRef
  • Long‐Term Survival With Minimum Side‐Effects in a Post‐Op Case of Carcinoma Esophagus With Multiple Recurrences in Mediastinum Treated With Radical Re‐Radiotherapy in Mediastinum—A Case Report
    Ajay Kumar Choubey, Pritam Mondal, Shubham Dokania, Sambit Swarup Nanda, Shreya Jain, Minesh Patel, Ashutosh Mukherji, Satyajit Pradhan
    Clinical Case Reports.2026;[Epub]     CrossRef
  • Chemoradiotherapy versus Chemotherapy Alone in Extensive-Stage Small Cell Esophageal Carcinoma: A Multicenter Retrospective Study Highlighting the Role of Radiotherapy (ChiSCEC)
    L. Peng, J. Zhu, J. Peng, Y. Wang, H. Sun, B. Zou, Y. Zhang, N. Yang, Z. Xiao, Y. Gui, X. Su, B. Tan, J. Ma, L. Peng, W. Zhang, W. Huang, Q. Wang
    Clinical Oncology.2026; 52: 104092.     CrossRef
  • Prognosis of Isolated Cervical Node Recurrence After Esophagectomy With Two-Field Lymphadenectomy for Esophageal Squamous Cell Carcinoma
    Yeong Jeong Jeon, Jeong A. Son, Junghee Lee, Seong Yong Park, Jong Ho Cho, Yong Soo Choi, Young Mog Shim, Jong-Mu Sun, Sehhoon Park, Dongryul Oh, Hong Kwan Kim
    The Annals of Thoracic Surgery.2026; 121(6): 1356.     CrossRef
  • Anlotinib combined with chemoradiotherapy for postoperative isolated lymph node recurrence of ESCC: a phase II study
    Jing Huang, Zhenlin Gu, Jinjing Xu, Changhua Yu, Weiguo Zhu, Yiyuan Zhang, Yong Gao
    Frontiers in Immunology.2026;[Epub]     CrossRef
  • Outcomes Of Neoadjuvant Chemoradiation Vs Neoadjuvant Chemotherapy for Esophageal Junction Signet Ring Cell Adenocarcinoma
    Zamaan Hooda, Dylan Langburt, Ana McCracken, Gabriele Carbone, Shanique Ries, Mara B. Antonoff, Arlene M. Correa, Reza Mehran, Ravi Rajaram, David Rice, Stephen Swisher, Ara Vaporciyan, Garrett Walsh, Kyle G. Mitchell, Lorenzo Ferri, Wayne Hofstetter
    The Annals of Thoracic Surgery.2026;[Epub]     CrossRef
  • Salvage Chemoradiotherapy for Loco-Regional Recurrence of Esophageal Squamous Cell Carcinoma After Esophagectomy
    Atsuto Katano, Tomoki Kiritoshi, Subaru Sawayanagi, Hideomi Yamashita
    Journal of Clinical Medicine.2025; 14(5): 1540.     CrossRef
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Salvage Concurrent Chemo-radiation Therapy for Loco-regional Recurrence Following Curative Surgery of Non-small Cell Lung Cancer
Kyung Hwa Lee, Yong Chan Ahn, Hongryull Pyo, Jae Myoung Noh, Seung Gyu Park, Tae Gyu Kim, Eonju Lee, Heerim Nam, Hyebin Lee, Jong-Mu Sun, Jin Seok Ahn, Myung-Ju Ahn, Keunchil Park
Cancer Res Treat. 2019;51(2):769-776.   Published online September 11, 2018
DOI: https://doi.org/10.4143/crt.2018.366
AbstractAbstract PDFPubReaderePub
Purpose
This study is to report clinical outcomes of salvage concurrent chemo-radiation therapy (CCRT) in treating patients with loco-regional recurrence (LRR) following initial complete resection of non-small cell lung cancer.
Materials and Methods
Between February 2004 and December 2016, 127 patients underwent salvage CCRT for LRR. The median radiation therapy (RT) dose was 66 Gy and clinical target volume was to cover recurrent lesion with margin without elective inclusion of regional lymphatics. Majority of patients (94.5%) received weekly platinum-based doublet chemotherapy during RT course.
Results
The median follow-up time from the start of CCRT was 25 months. The median survival duration was 49 months, and overall survival (OS) rates at 2 and 5 years were 72.9% and 43.9%. The 2- and 5-year rates of in-field failure-free survival, distant metastasis free survival, and progression free survival were 82.4% and 73.8%, 50.4% and 39.9%, and 34.6% and 22.3%, respectively. Grade ≥ 3 radiation-related esophagitis and pneumonitis occurred in 14 (11.0%) and six patients (4.7%), respectively. On both univariate and multivariate analysis, higher biologically equivalent dose (BED10) (≥ 79.2 Gy10 vs. < 79.2 Gy10; hazard ratio [HR], 0.431), smaller CTV (≤ 80 cm3 vs. > 80 cm3; HR, 0.403), and longer disease-free interval (> 1 year vs. ≤ 1 year; HR, 0.489) were significantly favorable factors for OS.
Conclusion
The current study has demonstrated that high dose salvage CCRT focused to the involved lesion only was highly effective and safe. In particular, higher BED10, smaller CTV, and longer disease-free interval were favorable factors for improved survival.

Citations

Citations to this article as recorded by  
  • Impact of lymphadenectomy extent on immunotherapy efficacy in postresectional recurred non-small cell lung cancer: a multi-institutional retrospective cohort study
    Hongsheng Deng, Juan Zhou, Hualin Chen, Xiuyu Cai, Ran Zhong, Feng Li, Bo Cheng, Caichen Li, Qingzhu Jia, Caicun Zhou, René H. Petersen, Gaetano Rocco, Alex Brunelli, Calvin S.H. Ng, Thomas A. D’Amico, Chunxia Su, Jianxing He, Wenhua Liang, Bo Zhu
    International Journal of Surgery.2024; 110(1): 238.     CrossRef
  • Prognosis of non‐small cell lung cancer with postoperative regional lymph node recurrence
    Yoichi Ohtaki, Toshiteru Nagashima, Naoko Okano, Nobuteru Kubo, Takeru Ohtaka, Noriaki Sunaga, Reiko Sakurai, Yosuke Miura, Seshiru Nakazawa, Natsuko Kawatani, Tomohiro Yazawa, Ryohei Yoshikawa, Eiji Narusawa, Ken Shirabe
    Thoracic Cancer.2024; 15(11): 859.     CrossRef
  • Durvalumab after chemoradiotherapy for locoregional recurrence of completely resected non–small‐cell lung cancer (NEJ056)
    Megumi Furuta, Hidehito Horinouchi, Isao Yokota, Teppei Yamaguchi, Shoichi Itoh, Takafumi Fukui, Akira Iwashima, Jun Sugisaka, Yu Miura, Hisashi Tanaka, Taichi Miyawaki, Hiroshi Yokouchi, Keita Miura, Ryota Saito, Go Saito, Tatsuhiko Kamoshida, Yusuke Uch
    Cancer Science.2024; 115(11): 3705.     CrossRef
  • Treatment patterns and survival of patients with locoregional recurrence in early-stage NSCLC: a literature review of real-world evidence
    Kathleen Bowes, Nick Jovanoski, Audrey E. Brown, Danilo Di Maio, Rossella Belleli, Shkun Chadda, Seye Abogunrin
    Medical Oncology.2022;[Epub]     CrossRef
  • Salvage proton beam therapy for locoregional recurrence of non-small cell lung cancer
    Hyunju Shin, Jae Myoung Noh, Hongryull Pyo, Yong Chan Ahn, Dongryul Oh
    Radiation Oncology Journal.2021; 39(1): 24.     CrossRef
  • Hypo-fractionated radiotherapy with concurrent chemotherapy for locoregional recurrence of non-small cell lung cancer after complete resection: A prospective, single-arm, phase II study (GASTO-1017)
    NaiBin Chen, QiWen Li, SiYu Wang, Mai Xiong, YiFeng Luo, Bin Wang, Li Chen, MaoSheng Lin, XiaoBo Jiang, JianLan Fang, SuPing Guo, JinYu Guo, Nan Hu, XinLei Ai, DaQuan Wang, Chu Chu, FangJie Liu, Hao Long, JunYe Wang, Bo Qiu, Hui Liu
    Lung Cancer.2021; 156: 82.     CrossRef
  • Salvage radiation therapy for postoperative locoregionally recurrent non-small cell lung cancer: a single-center experience
    Yoon Young Jo, Su Ssan Kim, Si Yeol Song, Eun Kyung Choi
    Radiation Oncology Journal.2021; 39(3): 210.     CrossRef
  • Propensity score adjusted analysis of patients with isolated locoregional recurrence versus de novo locally advanced NSCLC treated with definitive therapy
    Cole Friedes, Nicholas Mai, Wei Fu, Chen Hu, Peijin Han, Kristen A. Marrone, K. Ranh Voong, Russell K. Hales
    Lung Cancer.2020; 145: 119.     CrossRef
  • 12,372 View
  • 237 Download
  • 12 Web of Science
  • 8 Crossref
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Pattern of Recurrence after Curative Resection of Gastric Cancer
Jae Hong Jang, Young Jin Kim, Dong Yi Kim, Hyung Rok Kim, Shin Kon Kim
J Korean Cancer Assoc. 1999;31(3):466-472.
AbstractAbstract PDF
PURPOSE
Despite radical lymph node dissection and combined resection, the operative result of progressive gastric cancer remains unsatisfactory. The prognosis of gastric cancer has not been improved. In case of recurred gastric cancer, the problem is low curative resection rate. We tried to study the pattem of recurrence after curative resection for gastric cancer.
MATERIALS AND METHODS
We had retrospectively analyzed the recurrence pattern of 191 patients who recurred after curative resection of gastric cancer. We analyzed the interval between operation and recurrence, primary tumor location, tumor histologic type, Borrmann's type, pathologic stage, DNA ploidy pattem and lymph node metastasis.
RESULT
The number of recurred gastric cancer patients was 191. The M: F ratio was 2.03: 1. Seven cases were early gastric cancer. The interval between operation and recurrence was from 1 month to 130 months. The early recurrence within 24 months was found in 147 patients (77.0%), the intermediate recurrence from 25 months to 60 months was found in 38 patients (19.9%), the late reeurrence after 60 months was found in 6 patients (3.1%). The pattems of recurrence were as follows: loco-regional recurience, including lymph node and site of anastomosis, was found in 51 cases, liver metastasis in 37 cases, peritoneal metastasis in 74 cases, extraperitoneal metastasis in 29 cases including Virchows node. In undifferentiated cancer, peritoneal metastasis was higher than in other histologic types (p<0.05). 59 cases was found in stage IV, 47 cases in stage IIIb, 43 cases in stage IIIa, 31 cases in stage II, 8 cases in stage Ib, and 3 cases in stage Ia. We found peritoneal metastasis was very high in stage IIIb. The 5-year survival was better in loco-regional group than that of other patterns of recurrence.
CONCLUSION
Recurrence after operation was found within 24 months, that in most of patients, so the follow up is very important in this period and the recurred pattem after curative resection for gastric cancer was related with cell differentiation of primary tumor and stage. In local recurrence, the survival rate was higher than the other pattern of recurrence.
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