Local treatment of oligometastatic disease: current role

Abstract

The presence of distant metastases has long been a predictor of poor outcome in solid cancer. However, in an oncologic situation called oligometastatic disease (OMD), multiple studies have revealed a survival benefit with aggressive treatment of these metastases. Besides surgery and radiation therapy, local thermal therapies have developed into a treatment option for OMD. Most studies concerning local therapy of OMD are available for colorectal cancer, which is therefore the focus of this article. Furthermore, this review gives a basic overview of the most popular ablation techniques for treatment of OMD.

The pattern and treatment outcomes for rectal cancer with concurrent locoregional recurrence and distant metastases after total mesorectal excision

“…Furthermore, we found patients with OMD can achieve NED status after treatments more frequently. Consequently, patients with OMD after TME are the candidates to pursue NED status through upfront curative resection from the initial of the treatment, including CRT and RFA (11,12).…”

The pattern and treatment outcomes for rectal cancer with concurrent locoregional recurrence and distant metastases after total mesorectal excision

“…Furthermore, we found patients with OMD can achieve NED status after treatments more frequently. Consequently, patients with OMD after TME are the candidates to pursue NED status through upfront curative resection from the initial of the treatment, including CRT and RFA [ 21 , 22 ].…”

Oligometastatic Cancer: Key Concepts and Research Opportunities for 2021 and Beyond

“…Compared with a leukaemia-like dissemination of many malignant processes, the encouraging aspect of a spatially limited oligometastatic disease has ignited a steep rise of scientific interest with new research questions and challenges. We have divided them in three main categories, summarized in Table 1 [ 2 , 3 , 4 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. One of the major drawbacks of the oligometastatic concept is the current perception relying on therapeutic opportunity and cross-sectional imaging rather than intra- and intercellular processes [ 7 ].…”

“…If we accept the contemporary definition and its shortcomings, the next step is to determine the optimal treatment strategy. The body of existing evidence, especially from phase III trials, is far from satisfactory, and improvements are already needed at the level of study design with respect to clinical endpoints and the choice of modalities [ 9 , 24 , 29 ]. The latter aspect may indeed be crucial not only due to the large range of possible treatment options and indications, but also because of various combinations and sequencing schedules [ 9 , 14 , 15 , 16 , 17 , 18 ].…”

“…Despite these controversies and information gaps, local approaches should be praised for their cost-effectiveness, compliance, and low toxicity [ 21 , 24 , 30 ]. Moreover, oligometastases provide a new and exciting area of scientific opportunities.…”