My practice is to treat this exactly like de novo locally advanced disease. This means that the patient needs to be carefully (re-)staged, including with PET/CT scan, possibly an EUS, and most importantly, a diagnostic laparoscopy. Recurrence at the anastomosis can certainly also be associated with ...

What my dear friend Dr. @Daniel V. Catenacci writes is, of course, entirely correct. I did say in my response that a discussion of the peri-operative vs. TNT (an acronym we really need to handle with care!) approach is beyond the scope of the original question. However, to be provocative, I wo...