Kroese Tiuri E, Bronzwaer Sebastiaan F C, van Rossum Peter S N, van Laarhoven Hanneke W M, van Hillegersberg Richard
Department of Radiation Oncology, University Hospital Zürich, University of Zurich, Rämistrasse 100, Zürich, 8091, Switzerland.
Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Curr Oncol Rep. 2025 Jan;27(1):30-36. doi: 10.1007/s11912-024-01625-3. Epub 2025 Jan 3.
This narrative review aims to provide an overview of recently completed randomized trials and expert consensus recommendations, and their implications for clinical practice and future trial design in patients with de-novo esophagogastric oligometastatic disease (OMD).
The IKF-575/RENAISSANCE phase III trial showed no significant overall survival difference between systemic therapy alone and systemic therapy combined with local therapy for patients with gastric or gastroesophageal junction cancer and de-novo OMD, except for patients with retroperitoneal lymph node metastases only. The ESO-Shanghai 13 phase II trial demonstrated superiority of adding local therapy to systemic therapy for progression-free and overall survival in oligometastatic esophageal squamous cell carcinoma. The OMEC project developed a multidisciplinary European consensus for OMD, proposing a restrictive definition of OMD. Clinical trial assessing the optimal treatment of care are urgently needed. The findings highlight the importance of strict patient selection for local metastasis-directed treatment and the need for stratifying patients based on histology and location of metastases. Future research should focus on identifying biomarkers and clinical features to guide multidisciplinary treatment approaches for OMD.
本叙述性综述旨在概述近期完成的随机试验和专家共识推荐，以及它们对初发性食管胃交界部寡转移疾病（OMD）患者临床实践和未来试验设计的影响。
IKF-575/复兴III期试验表明，对于胃或胃食管交界癌及初发性OMD患者，单纯全身治疗与全身治疗联合局部治疗相比，总体生存率无显著差异，但仅腹膜后淋巴结转移患者除外。ESO-上海13 II期试验证明，在寡转移食管鳞状细胞癌中，全身治疗联合局部治疗在无进展生存期和总生存期方面具有优势。OMEC项目针对OMD制定了多学科欧洲共识，提出了OMD的严格定义。迫切需要评估最佳治疗方案的临床试验。这些发现强调了严格选择患者进行局部转移导向治疗的重要性，以及根据组织学和转移部位对患者进行分层的必要性。未来的研究应侧重于确定生物标志物和临床特征，以指导OMD的多学科治疗方法。
