PD02.05. Long-Term Incidence and Treatment Outcomes of Gastric Conduit Cancer After Esophagectomy

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ID: 325721
2026
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Abstract
Abstract Topic Esophageal Cancer: Other Background Gastric conduit cancer (GCC), a primary carcinoma arising in the reconstructed gastric conduit after esophagectomy, is rare, and its true incidence and long-term outcomes remain unclear. We aimed to determine its cumulative incidence and treatment-related outcomes. Methods We retrospectively reviewed 4,490 patients who underwent esophagectomy with gastric conduit reconstruction between 1994 and August 2025. Among them, 93 developed GCC during follow-up. Clinical characteristics and treatment outcomes of these patients were analyzed. Results The cumulative incidence of GCC was 2.22% at 10 years and 3.16% at 20 years, with a median interval of 48.2 months (IQR, 26.0–94.1) from esophagectomy to diagnosis. All tumors were adenocarcinomas. Surgical resection was performed in 14 patients (take-down of gastric conduit and colon interposition, n=11; partial gastrectomy or wedge resection, n=3) without postoperative mortality, with a median event-free survival (EFS) of 107.9 months and a 5-year EFS of 77.9%. Endoscopic therapy was the most common treatment (n=64; endoscopic submucosal dissection (ESD), n=62; argon plasma coagulation, n=2), with a median EFS of 56.4 months and a 5-year EFS of 48.2%; two patients required salvage surgery, and seven experienced recurrence at a median of 30.9 months. Eight patients received radiation therapy / concurrent chemoradiation therapy (median EFS 83.0 months; 5-year EFS 60.0%), and eight underwent chemotherapy or palliative care (median EFS 11.1 months; 5-year EFS 0%). Conclusion GCC remains a clinically significant long-term complication after esophagectomy. Endoscopic therapy offers favorable outcomes for early-stage disease, whereas advanced-stage GCC carries a poor prognosis. Therefore, structured and lifelong endoscopic surveillance is crucial for early detection and for improving long-term survival after esophagectomy.
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Authors Hyun Ki Jeong, Sung Yong Park, Tae Se Kim, Yang Won Min, Dong Ryul Oh, S. Park, Jong Mu Sun, Yeong Jeong Jeon, Jung Hee Lee, Jong Ho Cho, Hong Kwan Kim, Yong Soo Choi
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.083
URL
https://doi.org/10.1093/dote/doag077.083
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