Treatment of Recurrent and Metastatic Esophageal Cancer

There are few studies of the treatment of relapse in patients with esophageal squamous cell cancer (ESCC). Moreover, those trials were not randomized and without convincing data. Cumulative overall 1-year and 2-year survival rates after recurrence were around 30% and 12%, respectively, with a median survival of 6 months [1]. For this reason, the goal of the treatment is usually adequate palliation instead of cure, taking into account many factors: patient characteristics (performance status, age, co-morbidity), mode of relapse (local vs. locoregional vs. systemic), site of the primary cancer (non-local recurrences are more frequent in cervical or upper thoracic cancers) [2]; site of relapse (liver recurrence is the worst prognostic site, with a median overall survival < 6 months) [3]; kinetics of relapse (indolent or aggressive, symptomatic or asymptomatic disease); and previous treatments and their toxicities.