Recurrence: Treatment or Just Palliation?

Recurrent esophago-gastric junction adenocarcinoma is not a rare event but its correct management is still debated. Many different approaches to the treatment of these patients exist, but only few studies compare the different techniques. Most of the studies are retrospectives series and describe the experiences of single institutions in the treatment of recurrent esophageal and esophago-gastric junction cancer. Nowadays, surgery is still the main and only treatment for curative intent. Among the alternative therapies that only have a palliative purpose is: endoscopic stent placement and balloon dilation, photodynamic therapy, thermal tumor ablation (laser photoablation and Argon plasma coagulation), radiation therapy and brachytherapy, and chemotherapy. The aim of this review is to investigate the different rates, patterns and timings of recurrence of this tumor, and eventually to explain the various approaches used for treating the recurrent esophago-gastric junction cancer.