Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: a Delphi consensus study in Europe.
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Author
Kroese, Tiuri Evan Laarhoven, Hanneke W M
Schoppman, Sebastian F
Deseyne, Pieter R A J
van Cutsem, Eric
Haustermans, Karin
Nafteux, Philippe
Thomas, Melissa
Obermannova, 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
D'Ugo, Domenico
Roviello, Franco
Bencivenga, Maria
de Manzoni, Giovanni
van Berge Henegouwen, Mark I
Hulshof, Maarten C C M
van Dieren, Jolanda
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
Beerepoot, Laurens V
Mohammad, Nadia H
Mook, Stella
Ruurda, Jelle P
Kolodziejczyk, Piotr
Polkowski, Wojciech P
Wyrwicz, Lucjan
Alsina, Maria
Pera, Manuel
Kanonnikoff, Tania F
Cervantes, Andrés
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
Publication date
2023-02-24
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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.Citation
Kroese TE, van Laarhoven HWM, Schoppman SF, Deseyne PRAJ, van Cutsem E, Haustermans K, Nafteux P, Thomas M, Obermannova R, Mortensen HR, Nordsmark M, Pfeiffer P, Elme A, Adenis A, Piessen G, Bruns CJ, Lordick F, Gockel I, Moehler M, Gani C, Liakakos T, Reynolds J, Morganti AG, Rosati R, Castoro C, Cellini F, D'Ugo D, Roviello F, Bencivenga M, de Manzoni G, van Berge Henegouwen MI, Hulshof MCCM, van Dieren J, Vollebergh M, van Sandick JW, Jeene P, Muijs CT, Slingerland M, Voncken FEM, Hartgrink H, Creemers GJ, van der Sangen MJC, Nieuwenhuijzen G, Berbee M, Verheij M, Wijnhoven B, Beerepoot LV, Mohammad NH, Mook S, Ruurda JP, Kolodziejczyk P, Polkowski WP, Wyrwicz L, Alsina M, Pera M, Kanonnikoff TF, Cervantes A, Nilsson M, Monig S, Wagner AD, Guckenberger M, Griffiths EA, Smyth E, Hanna GB, Markar S, Chaudry MA, Hawkins MA, Cheong E, van Hillegersberg R, van Rossum PSN; OMEC collaborators. Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe. Eur J Cancer. 2023 May;185:28-39. doi: 10.1016/j.ejca.2023.02.015. Epub 2023 Feb 24.Type
ArticleAdditional Links
https://www.sciencedirect.com/journal/european-journal-of-cancerPMID
36947929Journal
European Journal of CancerPublisher
Elsevierae974a485f413a2113503eed53cd6c53
10.1016/j.ejca.2023.02.015