尽管局部晚期食管胃腺癌的多模式治疗有所改善，但大多数患者仍然会复发。结构化随访对于早期发现复发的影响尚不清楚，受到争议。本研究纳入2009年至2021年间接受新辅助/围手术期化疗后肿瘤切除的局部晚期食管胃腺癌患者，进行了结构化随访。在前2年内进行每3个月的影像学检查，之后在第3-4年和第5年分别进行半年和年度检查。分析了临床结果，包括复发的模式和时间点。共纳入257名患者进行分析。在50.2％（n = 129）的患者中，诊断为复发性疾病，其中大多数（94.6％）在前2年内复发。复发的最常见部位为淋巴结转移，其次为腹膜癌和肝肺转移。52.7％的患者在复发时有症状。高风险组（经新辅助治疗后具有淋巴结阳性的肿瘤（ypN +））与低风险组（无淋巴结转移原发肿瘤（ypN0））之间的累积复发风险和时间点差异显著。高风险患者的无病生存（DFS）和总体生存（OS）显著差异，分别为11.1和29.0个月，而低风险组的中位DFS和OS尚未达到。高风险患者与低风险患者的复发风险显著不同。只有部分复发与临床症状相关。针对高风险和低风险患者的个体化随访策略，应考虑个体化复发风险。©2023。作者（们）

Despite improvements in multimodal treatment of locally advanced esophagogastric adenocarcinoma, the majority of patients still relapses. The impact of structured follow-up for early detection of recurrence is unclear and controversially discussed.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 years, followed by semiannual and annual examinations in year 3-4 and 5, respectively. Clinical outcome including pattern and time point of relapse was analyzed.Two hundred fifty-seven patients were included in this analysis. In 50.2% (n = 129) of patients, recurrent disease was diagnosed, with the majority (94.6%) relapsing within the first 2 years. 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 months, respectively, whereas median DFS and OS were not reached for the low-risk group.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.© 2023. The Author(s).