TY - JOUR
T1 - European clinical practice guidelines for the definition, diagnosis, and treatment of oligometastatic esophagogastric cancer (OMEC-4)
AU - Kroese, Tiuri E
AU - Bronzwaer, Sebastiaan
AU - van Rossum, Peter S N
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 V
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 - Hulshoff, Maarten C C M
AU - van Dieren, Jolanda
AU - Vollebergh, Marieke
AU - van Sandick, Johanna W
AU - Jeene, Paul
AU - Muijs, Christel
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 A P
AU - Berbee, Maaike
AU - Verheij, Marcel
AU - Mohammad, Nadia Haj
AU - Mook, Stella
AU - Ruurda, Jelle P
AU - van Hillegersberg, Richard
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/6
Y1 - 2024/6
N2 - 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.
18F-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.
AB - 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.
18F-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.
KW - Esophageal cancer
KW - Gastric cancer
KW - Metastasectomy
KW - Metastasis
KW - Oligometastasis
KW - Stereotactic body radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85191296748&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2024.114062
DO - 10.1016/j.ejca.2024.114062
M3 - Article
C2 - 38678762
SN - 0959-8049
VL - 204
JO - European Journal of Cancer
JF - European Journal of Cancer
M1 - 114062
ER -