Is Oligometastatic Cancer Curable? A Survey of Oncologist Perspectives, Decision Making, and Communication

Cho, Hae Lin; Balboni, Tracy A.; Christ, Sebastian M.; Turner, B. E.; Spektor, Alexander; Perni, Subha

doi:10.1016/j.adro.2023.101221

Cited by 2 publications

(1 citation statement)

References 32 publications

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“…A survey of medical and radiation oncologists found no common understanding of oligometastatic disease and significant variability in treatment recommendations. 19 …”

Section: Defining Oligometastatic Diseasementioning

confidence: 99%

Surgery for Oligometastatic Pancreatic Cancer: Defining Biologic Resectability

Koti,

Demyan,

Deutsch

et al. 2024

Ann Surg Oncol

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Pancreatic ductal adenocarcinoma (PDAC) is most often metastatic at diagnosis. As systemic therapy continues to improve alongside advanced surgical techniques, the focus has shifted toward defining biologic, rather than technical, resectability. Several centers have reported metastasectomy for oligometastatic PDAC, yet the indications and potential benefits remain unclear. In this review, we attempt to define oligometastatic disease in PDAC and to explore the rationale for metastasectomy. We evaluate the existing evidence for metastasectomy in liver, peritoneum, and lung individually, assessing the safety and oncologic outcomes for each. Furthermore, we explore contemporary biomarkers of biological resectability in oligometastatic PDAC, including radiographic findings, biochemical markers (such as CA 19-9 and CEA), inflammatory markers (including neutrophil-to-lymphocyte ratio, C-reactive protein, and scoring indices), and liquid biopsy techniques. With careful consideration of existing data, we explore the concept of biologic resectability in guiding patient selection for metastasectomy in PDAC.

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“…A survey of medical and radiation oncologists found no common understanding of oligometastatic disease and significant variability in treatment recommendations. 19 …”

Section: Defining Oligometastatic Diseasementioning

confidence: 99%

Surgery for Oligometastatic Pancreatic Cancer: Defining Biologic Resectability

Koti,

Demyan,

Deutsch

et al. 2024

Ann Surg Oncol

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Is it too early to recommend local treatment in oligometastatic non-small cell lung cancer: a plea for equipoise

Ahmad,

Chufal,

Miller

et al. 2024

British Journal of Radiology

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Oligometastatic Non-Small Cell Lung cancer (OMD NSCLC) has been proposed to bridge the spectrum between non-metastatic to widely metastatic states and is perceived as an opportunity for potential cure if removed. Twelve clinical trials on local treatment have been reported, yet none are conclusive. These trials informed the development of a joint clinical practice guideline (CPG) by the American & European societies for radiation oncology, which endorses local treatment for OMD NSCLC. However, the heterogeneity between and prognostic factors within these trials likely influenced outcomes and can only support guidance at this time. Caution against an uncritical acceptance of the guideline is discussed, as strong recommendations are offered based on expert opinion and inconclusive evidence. The guideline is also examined by a patient’s caregiver, who emphasizes that uncertain evidence impedes shared decision-making.

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Is Oligometastatic Cancer Curable? A Survey of Oncologist Perspectives, Decision Making, and Communication

Cited by 2 publications

References 32 publications

Surgery for Oligometastatic Pancreatic Cancer: Defining Biologic Resectability

Surgery for Oligometastatic Pancreatic Cancer: Defining Biologic Resectability

Is it too early to recommend local treatment in oligometastatic non-small cell lung cancer: a plea for equipoise

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