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

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: Local treatment for oligo-recurrence is associated with improved survival outcomes in selected patients with recurrent esophageal cancer.