Department of Pulmonary Diseases, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Pulmonary Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands; GROW - School for oncology and developmental biology, University Maastricht, The Netherlands.
Department of Pulmonary Diseases, Maastricht University Medical Center+, Maastricht, the Netherlands; GROW - School for oncology and developmental biology, University Maastricht, The Netherlands.
J Thorac Oncol. 2019 Dec;14(12):2109-2119. doi: 10.1016/j.jtho.2019.07.025. Epub 2019 Aug 6.
Improved outcome has been shown in patients with synchronous oligometastatic (sOM) NSCLC when treated with radical intent. As a uniform definition of sOM NSCLC is lacking, we developed a definition and diagnostic criteria by a consensus process.
A pan-European multidisciplinary consensus group was established. Consensus questions were built on the basis of current controversies, and definitions were extracted from a survey, cases and a systematic review. This statement was formulated during a consensus meeting.
It was determined that definition of sOM NSCLC is relevant when a radical treatment that may modify the disease course (leading to long-term disease control) is technically feasible for all tumor sites with acceptable toxicity. On the basis of the review, a maximum of five metastases and three organs was proposed. Mediastinal lymph node involvement was not counted as a metastatic site. Fludeoxyglucose F 18 positron emission tomography-computed tomography and brain imaging were considered mandatory. A dedicated liver magnetic resonance imaging scan was advised for a solitary liver metastasis, and thoracoscopy and biopsies of distant ipsilateral pleural sites were recommended for a solitary pleural metastasis. For mediastinal staging, fludeoxyglucose F 18 positron emission tomography-computed tomography was deemed the minimum requirement, with pathological confirmation recommended if this influences the treatment strategy. Biopsy of a solitary metastatic location was mandated unless the multidisciplinary team is of the opinion that the risks outweigh the benefits.
A multidisciplinary consensus statement on the definition and staging of sOM NSCLC has been formulated. This statement will help to standardize inclusion criteria in future clinical trials.
对于同步寡转移（sOM）非小细胞肺癌（NSCLC）患者，采用根治性治疗已显示出改善的预后。由于缺乏对 sOM NSCLC 的统一定义，我们通过共识过程制定了一个定义和诊断标准。
成立了一个泛欧多学科共识小组。共识问题基于当前的争议点构建，定义则从调查、病例和系统综述中提取。本陈述是在共识会议期间制定的。
确定 sOM NSCLC 的定义是相关的，当针对所有肿瘤部位采用可能改变疾病进程（导致长期疾病控制）的根治性治疗在技术上可行且毒性可接受时。基于综述，提出了最多五个转移灶和三个器官的限制。纵隔淋巴结受累不视为转移部位。氟脱氧葡萄糖 F 18 正电子发射断层扫描-计算机断层扫描和脑部成像被认为是强制性的。对于孤立性肝转移，建议进行专门的肝脏磁共振成像扫描；对于孤立性胸膜转移，建议进行胸腔镜检查和对侧胸膜远处部位的活检。对于纵隔分期，氟脱氧葡萄糖 F 18 正电子发射断层扫描-计算机断层扫描被认为是最低要求，如果这影响治疗策略，则推荐进行病理证实。除非多学科团队认为风险大于收益，否则应进行孤立转移部位的活检。
制定了关于 sOM NSCLC 的定义和分期的多学科共识声明。本声明将有助于在未来的临床试验中标准化纳入标准。
