Half of esophageal cancer patients face recurrence after surgery, with significant implications for patient management.

• Of 1,310 patients with recurrence, 37.3% had it at multiple distant sites, while 14.4% experienced isolated local recurrence.
• Liver-only recurrence was detected significantly earlier (median 9 months) and had the poorest survival (7.4 months post-recurrence).

Surgeons should tailor postoperative surveillance based on recurrence patterns to optimize patient outcomes.

• Lung-only and local-only recurrences had better survival rates of 10.4 and 15.9 months, respectively.