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The impact of structured follow-up for early detection of recurrence is unclear and controversially discussed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with locally advanced esophagogastric adenocarcinoma having received neoadjuvant\/perioperative chemotherapy followed by tumor resection between 2009 and 2021, underwent a structured follow-up including three-monthly imaging during the first 2\u00a0years, followed by semiannual and annual examinations in year 3\u20134 and 5, respectively. Clinical outcome including pattern and time point of relapse was analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Two hundred fifty-seven patients were included in this analysis. In 50.2% (<jats:italic>n<\/jats:italic>\u2009=\u2009129) of patients, recurrent disease was diagnosed, with the majority (94.6%) relapsing within the first 2\u00a0years. The most common site of relapse were lymph node metastases followed by peritoneal carcinomatosis and hepatic and pulmonary metastases. 52.7% of patients presented with symptoms at the time of relapse. Cumulative risk and time point of relapse differed significantly between patient with a node-positive tumor (ypN+) after neoadjuvant treatment (high-risk group) and patients with node-negative primary tumor (ypN0) (low-risk group). High-risk patients had a significantly inferior disease-free survival (DFS) and overall survival (OS) with 11.1 and 29.0\u00a0months, respectively, whereas median DFS and OS were not reached for the low-risk group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The risk of relapse differs significantly between high- and low-risk patients. Only a part of relapses is associated with clinical symptoms. An individualized follow-up strategy is recommended for high- and low-risk patients considering the individual risk of relapse.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00432-023-05254-4","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T11:02:40Z","timestamp":1692270160000},"page":"14785-14796","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pattern and time point of relapse in locally advanced esophagogastric adenocarcinoma after multimodal treatment: implications for a useful structured follow-up"],"prefix":"10.1007","volume":"149","author":[{"given":"Ramona","family":"Stelmach","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonidas","family":"Apostolidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Kahle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leila","family":"Sisic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Nienh\u00fcser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim Frederik","family":"Weber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"J\u00e4ger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg Martin","family":"Haag","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,8,17]]},"reference":[{"key":"5254_CR1","doi-asserted-by":"publisher","first-page":"393","DOI":"10.6004\/jnccn.2023.0019","volume":"21","author":"JA Ajani","year":"2023","unstructured":"Ajani JA, D\u2019Amico TA, Bentrem DJ, Cooke D, Corvera C, Das P, Enzinger PC, Enzler T, Farjah F, Gerdes H, Gibson M, Grierson P, Hofstetter WL, Ilson DH, Jalal S, Keswani RN, Kim S, Kleinberg LR, Klempner S, Lacy J, Licciardi F, Ly QP, Matkowskyj KA, McNamara M, Miller A, Mukherjee S, Mulcahy MF, Outlaw D, Perry KA, Pimiento J, Poultsides GA, Reznik S, Roses RE, Strong VE, Su S, Wang HL, Wiesner G, Willett CG, Yakoub D, Yoon H, McMillian NR, Pluchino LA (2023) Esophageal and Esophagogastric Junction Cancers, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology. 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Lancet Oncol 15:1224-35","DOI":"10.1016\/S1470-2045(14)70420-6"}],"container-title":["Journal of Cancer Research and Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00432-023-05254-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00432-023-05254-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00432-023-05254-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T11:15:35Z","timestamp":1698318935000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00432-023-05254-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,17]]},"references-count":37,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["5254"],"URL":"https:\/\/doi.org\/10.1007\/s00432-023-05254-4","relation":{},"ISSN":["0171-5216","1432-1335"],"issn-type":[{"value":"0171-5216","type":"print"},{"value":"1432-1335","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,17]]},"assertion":[{"value":"19 June 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"RS received fees for an advisory board from Pfizer. Travel and Accommodations were provided by Astellas\u00a0and AVEO. LA received fees for an advisory role from Novartis, Roche, Bayer and Pfizer. He received speaker\u2019s honoraria from Ipsen, Novartis and Pfizer. He received research grants from Ipsen. Travel and Accommodations were provided by Ipsen, Novartis and Roche. SK received travel and accommodations from Ipsen Pharma. DJ received fees for an advisory role from CureVac AG, Definiens, F.Hoffmann-La Roche Ltd, Genmab A-S, Life Science Inkubator GmbH, VAXIMM AG, OncoOne Research & Development Research GmbH, Oncolytics Biotech Inc., Zelluna, HDIT GmbH, AYOXXA, Seattle Genetics, BreakBio Corp., Roche Pharma AG. He received speaker\u2019s honoraria from SKK Kliniken Heilbronn GmbH, Georg Thieme Verlag, Terrapinn, Touch Medical Media, BMS GmbH & Co KGaA, MSD, Guppe 5 Filmproduktion GmbH, AstraZeneca GmbH, Dept. of Radiation Medicine University Kentucky and The Norwegian Cancer Society Oslo. He received Payment for expert testimony from Epert opinions for courts, Wilhlem-Sander-Stiftung, Else-Kr\u00f6ner-Fesenius-Stiftung, Schering Stiftung, NordForsk Travel and Accomodations were provided by Amgen Inc., Oryx GmbH, Roche Glycart AG, Parexel.com, IKTZ HD GmbH, BMS. LS, HN and TFW have no conflicts of interest to declare. GMH received fees for an advisory role from Bristol-Myers Squibb, MSD Sharp & Dohme, EsoCap, Lilly and Novartis. He received speaker\u00b4s honoraria from Servier, MSD Sharp & Dohme, Lilly, Targos, Bristol-Myers Squibb. He received research grants from Nordic Pharma, Taiho Pharmaceutical, MSD Sharp & Dohme. Travel and Accommodations were provided by Bristol-Myers Squibb, Lilly, Servier, MSD Sharp & Dohme.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University Heidelberg.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Since this is a retrospective study, patient consent is not required according to the local ethical vote.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}