TY - JOUR
T1 - Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer
T2 - A Delphi consensus study in Europe
AU - Kroese, Tiuri E.
AU - van Laarhoven, Hanneke W. M.
AU - Schoppman, Sebastian F.
AU - Deseyne, Pieter R. A. J.
AU - van Cutsem., Eric
AU - Haustermans., Karin
AU - Nafteux, Philippe.
AU - Thomas, Melissa
AU - Obermannova, Radka
AU - Mortensen, Hanna R.
AU - Nordsmark, Marianne
AU - Pfeiffer, Per
AU - Elme, Anneli
AU - Adenis, Antoine
AU - Piessen, Guillaume
AU - Bruns, Christiane J.
AU - Lordick, Florian
AU - Gockel, Ines
AU - Moehler, Markus
AU - Gani, Cihan
AU - Liakakos, Theodore
AU - Reynolds, John
AU - Morganti, Alessio G.
AU - Rosati, Riccardo
AU - Castoro, Carlo
AU - Cellini, Francesco
AU - D'Ugo, Domenico
AU - Roviello, Franco
AU - Bencivenga, Maria
AU - de Manzoni, Giovanni
AU - Henegouwen, Mark I. van Berge
AU - Hulshof, Maarten C. C. M.
AU - van Dieren, Jolanda
AU - Vollebergh, Marieke
AU - van Sandick, Johanna W.
AU - Jeene, Paul
AU - Muijs, Christel T.
AU - Slingerland, Marije
AU - Voncken, Francine E. M.
AU - Hartgrink, Henk
AU - Creemers, Geert-Jan
AU - van der Sangen, Maurice J. C.
AU - Nieuwenhuijzen, Grard
AU - Berbee, Maaike
AU - Verheij, Marcel
AU - Wijnhoven, Bas
AU - V. Beerepoot, Laurens
AU - Mohammad, Nadia H.
AU - Mook, Stella
AU - Ruurda, Jelle P.
AU - van Rossum, Peter S. N.
AU - OMEC working group
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Background: Local treatment improves the outcomes for oligometastatic disease (OMD, i.e. an intermediate state between locoregional and widespread disseminated disease). However, consensus about the definition, diagnosis and treatment of oligometastatic oesopha-gogastric cancer is lacking. The aim of this study was to develop a multidisciplinary European consensus statement on the definition, diagnosis and treatment of oligometastatic oesophago-gastric cancer. Methods: In total, 65 specialists in the multidisciplinary treatment for oesophagogastric cancer from 49 expert centres across 16 European countries were requested to participate in this Del-phi study. The consensus finding process consisted of a starting meeting, 2 online Delphi ques-tionnaire rounds and an online consensus meeting. Input for Delphi questionnaires consisted of (1) a systematic review on definitions of oligometastatic oesophagogastric cancer and (2) a discussion of real-life clinical cases by multidisciplinary teams. Experts were asked to score each statement on a 5-point Likert scale. The agreement was scored to be either absent/poor (<50%), fair (50%-75%) or consensus (>75%). Results: A total of 48 experts participated in the starting meeting, both Delphi rounds, and the consensus meeting (overall response rate: 71%). OMD was considered in patients with meta-static oesophagogastric cancer limited to 1 organ with <3 metastases or 1 extra-regional lymph node station (consensus). In addition, OMD was considered in patients without pro-gression at restaging after systemic therapy (consensus). For patients with synchronous or me-tachronous OMD with a disease-free interval <2 years, systemic therapy followed by restaging to consider local treatment was considered as treatment (consensus). For metachronous OMD with a disease-free interval >2 years, either upfront local treatment or systemic treatment fol-lowed by restaging was considered as treatment (fair agreement). Conclusion: The OMEC project has resulted in a multidisciplinary European consensus state -ment for the definition, diagnosis and treatment of oligometastatic oesophagogastric adeno-carcinoma and squamous cell cancer. This can be used to standardise inclusion criteria for future clinical trials. 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
AB - Background: Local treatment improves the outcomes for oligometastatic disease (OMD, i.e. an intermediate state between locoregional and widespread disseminated disease). However, consensus about the definition, diagnosis and treatment of oligometastatic oesopha-gogastric cancer is lacking. The aim of this study was to develop a multidisciplinary European consensus statement on the definition, diagnosis and treatment of oligometastatic oesophago-gastric cancer. Methods: In total, 65 specialists in the multidisciplinary treatment for oesophagogastric cancer from 49 expert centres across 16 European countries were requested to participate in this Del-phi study. The consensus finding process consisted of a starting meeting, 2 online Delphi ques-tionnaire rounds and an online consensus meeting. Input for Delphi questionnaires consisted of (1) a systematic review on definitions of oligometastatic oesophagogastric cancer and (2) a discussion of real-life clinical cases by multidisciplinary teams. Experts were asked to score each statement on a 5-point Likert scale. The agreement was scored to be either absent/poor (<50%), fair (50%-75%) or consensus (>75%). Results: A total of 48 experts participated in the starting meeting, both Delphi rounds, and the consensus meeting (overall response rate: 71%). OMD was considered in patients with meta-static oesophagogastric cancer limited to 1 organ with <3 metastases or 1 extra-regional lymph node station (consensus). In addition, OMD was considered in patients without pro-gression at restaging after systemic therapy (consensus). For patients with synchronous or me-tachronous OMD with a disease-free interval <2 years, systemic therapy followed by restaging to consider local treatment was considered as treatment (consensus). For metachronous OMD with a disease-free interval >2 years, either upfront local treatment or systemic treatment fol-lowed by restaging was considered as treatment (fair agreement). Conclusion: The OMEC project has resulted in a multidisciplinary European consensus state -ment for the definition, diagnosis and treatment of oligometastatic oesophagogastric adeno-carcinoma and squamous cell cancer. This can be used to standardise inclusion criteria for future clinical trials. 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
KW - Oesophageal cancer
KW - Gastric cancer
KW - Metastasis
KW - Metastasectomy
KW - Stereotactic body radiotherapy
KW - Oligometastasis
KW - CLINICAL-PRACTICE GUIDELINE
KW - GASTROESOPHAGEAL JUNCTION
KW - SURGICAL RESECTION
KW - PLUS CHEMOTHERAPY
KW - GASTRIC-CANCER
KW - ESOPHAGEAL
KW - ADENOCARCINOMA
KW - NIVOLUMAB
KW - SURVIVAL
KW - CRITERIA
U2 - 10.1016/j.ejca.2023.02.015
DO - 10.1016/j.ejca.2023.02.015
M3 - Article
C2 - 36947929
SN - 0959-8049
VL - 185
SP - 28
EP - 39
JO - European Journal of Cancer
JF - European Journal of Cancer
IS - 1
ER -