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 - van Berge Henegouwen, Mark I.
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 - Beerepoot, Laurens V.
AU - Ruurda, Jelle P.
AU - van Rossum, Peter S. N.
AU - the OMEC collaborators
AU - Gootjes, Elske C.
AU - Mohammad, Nadia H.
AU - Mook, Stella
N1 - Publisher Copyright: © 2023 The Author(s)
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 oesophagogastric cancer is lacking. The aim of this study was to develop a multidisciplinary European consensus statement on the definition, diagnosis and treatment of oligometastatic oesophagogastric 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 Delphi study. The consensus finding process consisted of a starting meeting, 2 online Delphi questionnaire 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 metastatic 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 progression at restaging after systemic therapy (consensus). For patients with synchronous or metachronous 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 followed by restaging was considered as treatment (fair agreement). Conclusion: The OMEC project has resulted in a multidisciplinary European consensus statement for the definition, diagnosis and treatment of oligometastatic oesophagogastric adenocarcinoma and squamous cell cancer. This can be used to standardise inclusion criteria for future clinical trials.
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 oesophagogastric cancer is lacking. The aim of this study was to develop a multidisciplinary European consensus statement on the definition, diagnosis and treatment of oligometastatic oesophagogastric 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 Delphi study. The consensus finding process consisted of a starting meeting, 2 online Delphi questionnaire 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 metastatic 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 progression at restaging after systemic therapy (consensus). For patients with synchronous or metachronous 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 followed by restaging was considered as treatment (fair agreement). Conclusion: The OMEC project has resulted in a multidisciplinary European consensus statement for the definition, diagnosis and treatment of oligometastatic oesophagogastric adenocarcinoma and squamous cell cancer. This can be used to standardise inclusion criteria for future clinical trials.
KW - Gastric cancer
KW - Metastasectomy
KW - Metastasis
KW - Oesophageal cancer
KW - Oligometastasis
KW - Stereotactic body radiotherapy
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85150453275&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36947929
UR - http://www.scopus.com/inward/record.url?scp=85150453275&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ejca.2023.02.015
DO - https://doi.org/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
ER -