European clinical practice guidelines for the definition, diagnosis, and treatment of oligometastatic esophagogastric cancer (OMEC-4)

• Authors: KROESE Tiuri E; BRONZWAER Sebastiaan; VAN ROSSUM Peter S N; SCHOPPMAN Sebastian F; DESEYNE Pieter R A J; VAN CUTSEM Eric; HAUSTERMANS Karin; NAFTEUX Philippe; THOMAS Melissa; LORDICK 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 V; MORGANTI Alessio G; ROSATI Riccardo; CASTORO Carlo; CELLINI Francesco; D'UGO Domenico; ROVIELLO Franco; BENCIVENGA Maria; GIOVANNI de Manzoni; HENEGOUWEN Mark I van Berge; HULSHOFF Maarten C C M; VAN DIEREN Jolanda; VOLLEBERGH Marieke; VAN SANDICK Johanna W; JEENE Paul; MUIJS Christel; SLINGERLAND Marije; VONCKEN Francine E M; HARTGRINK Henk; CREEMERS Geert-Jan; VAN DER SANGEN Maurice J C; NIEUWENHUIJZEN Grard A P; BERBEE Maaike; VERHEIJ Marcel; WIJNHOVEN Bas; LAURENS V Beerepoot; MOHAMMAD Nadia Haj; MOOK Stella; RUURDA Jelle P; KOLODZIEJCZYK Piotr; POLKOWSKI Wojciech P; WYRWICZ Lucjan; ALSINA Maria; TABERNERO Josep; 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 LAARHOVEN Hanneke W M; VAN HILLEGERSBERG Richard
• Year of publication: 2024
• Type: Article in Periodical
• Magazine / Source: European Journal of Cancer
• MU Faculty or unit: Faculty of Medicine
• Web: https://www.sciencedirect.com/science/article/pii/S0959804924007184?via%3Dihub
• Doi: http://dx.doi.org/10.1016/j.ejca.2024.114062
• Keywords: Esophageal cancer; Gastric cancer; Metastasis; Metastasectomy; Stereotactic body radiotherapy; Oligometastasis
• Description: Introduction: The OligoMetastatic Esophagogastric Cancer (OMEC) project aims to provide clinical practice guidelines for the definition, diagnosis, and treatment of esophagogastric oligometastatic disease (OMD). Methods: Guidelines were developed according to AGREE II and GRADE principles. Guidelines were based on a systematic review (OMEC-1), clinical case discussions (OMEC-2), and a Delphi consensus study (OMEC-3) by 49 European expert centers for esophagogastric cancer. OMEC identified patients for whom the term OMD is considered or could be considered. Disease-free interval (DFI) was defined as the time between primary tumor treatment and detection of OMD. Results: Moderate to high quality of evidence was found (i.e. 1 randomized and 4 non-randomized phase II trials) resulting in moderate recommendations. OMD is considered in esophagogastric cancer patients with 1 organ with <= 3 metastases or 1 involved extra-regional lymph node station. In addition, OMD continues to be considered in patients with OMD without progression in number of metastases after systemic therapy. F-18-FDG PET/CT imaging is recommended for baseline staging and for restaging after systemic therapy when local treatment is considered. For patients with synchronous OMD or metachronous OMD and a DFI <= 2 years, recommended treatment consists of systemic therapy followed by restaging to assess suitability for local treatment. For patients with metachronous OMD and DFI > 2 years, upfront local treatment is additionally recommended. Discussion: These multidisciplinary European clinical practice guidelines for the uniform definition, diagnosis and treatment of esophagogastric OMD can be used to standardize inclusion criteria in future clinical trials and to reduce variation in treatment.