Management of Oligometastatic Disease in Esophagogastric Cancer: What Is the Evidence?

Abstract

Background: The concept of oligometastatic disease (OMD) was first introduced in 1995 by Hellman and Weichselbaum and described as stage of transition between localized and widespread metastatic disease. The presence of OMD in esophagogastric (OG) cancer remains controversial. Historically, most experts believe that OG cancer is systemic disease from the outset.

Summary: More recently, there is emerging data indicating improved outcomes in patients with OG cancer and oligometastatic disease. The present manuscript focuses on reviewing the emerging evidence in management of metastatic OG cancer with OMD and highlighting the direction of future research.

Key messages: Multiple retrospective and at least 2 phase II retrospective studies have reported on improved outcomes in patients with metastatic OG cancer and OMD. There is indication of improved outcome with combined systemic and local therapy (surgery or radiation). Further research should include phase III randomized studies to identify the optimal management algorithm in these groups of patients.