Oligometastatic Disease in Upper Gastrointestinal Cancer - How to Proceed?

Abstract

Background: In the present study we review and discuss the current evidence and suggest how to proceed in the management of oligometastatic disease in upper gastrointestinal cancer.

Methods: An electronic search of the PubMed database for relevant articles was performed.

Results: Both the search for 'oligometastasis', 'oligometastases', 'oligometastatic', 'oligometastatic disease' as well as 'esophageal' and 'esophageal cancer' and the search for 'oligometastasis', 'oligometastases', 'oligometastatic', 'oligometastatic disease' as well as 'gastric', 'gastric cancer', 'stomach', and 'stomach cancer' yielded very few studies. Most data need to be extrapolated in general studies on oligometastatic diseases of different origins. No randomized controlled trial could be found.

Conclusion: In the absence of data to formulate recommendations on how to proceed in the treatment of oligometastatic disease in upper gastrointestinal cancer, a more aggressive treatment of oligometastatic disease can be considered in patients whose tumors show a more favorable neoplastic behavior after the 'test of time'. The RENAISSANCE study will certainly deliver important data regarding this aspect.

Keywords: Gastrointestinal cancer; Oligometastases; Oligometastatic disease.

Fig. 1

Therapeutic management of oligometastatic disease in upper gastrointestinal cancer. The ‘test of time’ and the response to systemic treatment are currently the only useful markers for a more favorable and less aggressive biological behavior of the disease and encourage to pursue a more aggressive treatment.