The impact of histological subtype on postoperative recurrence pattern and timing in locally advanced esophagogastric junction cancer

Abstract Purpose The differences of tumoral behavior between histological subtypes of esophagogastric junction (EGJ) cancer have yet to be well investigated. The purpose of this study is to gain insights that can contribute to the tailored treatments and follow-up strategies by analyzing correlation between histological subtypes and oncological outcomes. Methods Retrospective analysis was used to determine the characteristics of the histological subtype of EGJ cancer by comparing the appearance of postoperative recurrences. A total of 102 consecutive cases of pathological Stage IIA to IVA EGJ cancer, who underwent R0 surgery in our department from 2004 to 2020, were enrolled. The recurrence pattern, timing, survival, and potential prognostic factors were compared. Results After a median follow-up time of 70.1 months, the AC group demonstrated a comparable lymph node metastasis-free survival (P = 0.291) and a significantly worse non-lymphogenous failure-free survival (P = 0.035) than the SCC group. A significantly longer period from surgery to recurrence in the AC group was also observed (P = 0.029). Multivariate analysis indicated that histological subtype (P = 0.015, 95% CI = 1.24–7.28) was significantly correlated with the incidence of non-lymphogenous recurrence. Conclusions The pattern and timing of postoperative recurrence for EGJ cancer were found to be significantly different between the histological subtypes. EGJ AC may have a stronger tendency of non-lymphogenous progression and a propensity for longer surgery-to-recurrence periods compared to EGJ SCC.