Publication details

Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe

Authors	KROESE Tiuri E VAN LAARHOVEN Hanneke W M SCHOPPMAN Sebastian F DESEYNE Pieter R A J VAN CUTSEM Eric HAUSTERMANS Karin NAFTEUX Philippe THOMAS Melissa OBERMANNOVÁ Radka MORTENSEN Hanna R NORDSMARK Marianne PFEIFFER Per ELME Anneli ADENIS Antoine PIESSEN Guillaume BRUNS Christiane J LORDICK Florian GOCKEL Ines MOEHLER Markus GANI Cihan LIAKAKOS Theodore REYNOLDS John MORGANTI Alessio G ROSATI Riccardo CASTORO Carlo CELLINI Francesco UGO Domenico ROVIELLO Franco BENCIVENGA Maria DE MANZONI Giovanni HENEGOUWEN Mark I van Berge HULSHOF Maarten C C M JOLANDA van Dieren VOLLEBERGH Marieke VAN SANDICK Johanna W JEENE Paul MUIJS Christel T SLINGERLAND Marije VONCKEN Francine E M HARTGRINK Henk CREEMERS Geert-Jan VAN DER SANGEN Maurice J C NIEUWENHUIJZEN Grard BERBEE Maaike VERHEIJ Marcel WIJNHOVEN Bas LAURENS V Beerepoot MOHAMMAD Nadia H MOOK Stella RUURDA Jelle P KOLODZIEJCZYK Piotr POLKOWSKI Wojciech P WYRWICZ Lucjan ALSINA Maria PERA Manuel KANONNIKOFF Tania F CERVANTES Andres NILSSON Magnus MONIG Stefan WAGNER Anna D GUCKENBERGER Matthias GRIFFITHS Ewen A SMYTH Elizabeth HANNA George B MARKAR Sheraz CHAUDRY M Asif HAWKINS Maria A CHEONG Edward VAN HILLEGERSBERG Richard VAN ROSSUM Peter S N
Year of publication	2023
Type	Article in Periodical
Magazine / Source	European Journal of Cancer
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.sciencedirect.com/science/article/pii/S095980492300103X?via%3Dihub
Doi	http://dx.doi.org/10.1016/j.ejca.2023.02.015
Keywords	Oesophageal cancer; Gastric cancer; Metastasis; Metastasectomy; Stereotactic body radiotherapy; Oligometastasis
Description	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/).