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How Esophageal Cancer Can Return After Treatment: Insights From the ESOPEC Trial

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Recurrence Patterns of Esophageal Adenocarcinoma in the Phase III ESOPEC Trial Comparing Perioperative Chemotherapy With Preoperative DOI- 10.1200JCO-25-00948

Esophageal adenocarcinoma is a type of cancer that affects the food pipe. Two major treatment plans are often used before surgery: one uses only chemotherapy (called FLOT), and the other uses chemotherapy with radiation (called CROSS). This study compared both options to see which worked better at preventing cancer from coming back.

Researchers followed 438 patients from the ESOPEC trial. Most had surgery after their treatment. After almost 5 years, they looked at how many patients stayed cancer-free.

Here’s what they found:

⦿ FLOT (chemo only) patients had better results overall. About 55% stayed cancer-free for 3 years, compared to 39% in the CROSS group.
⦿ The number of local recurrences (cancer coming back in the same area) was about the same in both groups.
⦿ But FLOT reduced the risk of the cancer spreading to other parts of the body, which made the biggest difference.

This shows that for many patients with this type of cancer, chemotherapy alone may do a better job of preventing the cancer from spreading, leading to better survival.

If you or someone you love is facing esophageal cancer, ask your doctor about FLOT and CROSS and which treatment might be right for your case.

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Dr Harsh Shah - GI & HPB Oncosurgeon in Ahmeadbad
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