Oligo-Recurrence in Lung Cancer; The Most Curable State Among Advanced Disease?

Abstract

Despite the introduction of effective systemic therapies and advancements in precision medicine, recurrence or progression remains common in advanced non-small cell lung cancer (NSCLC). For a subset of patients with more localized metastatic disease-referred to as oligometastases and oligo-recurrence-emerging evidence suggests that a multimodal approach combining systemic therapy with local ablative therapies (LATs) may offer curative potential. Oligo-recurrence is defined by the presence of a limited number of metastases and recurrences in patients with controlled primary lesions. In this review, we focus on providing a comprehensive overview of the evidence supporting the concepts of oligo-recurrence in lung cancer, which is considered one of the most curable states among advanced diseases. Although the definition remains variable and is still under discussion, retrospective studies have reported that it is not a rare condition (occurring in 18-53% of cases) and shows relatively better survival outcomes regardless of whether a local ablative therapy (LAT) is performed. However, this classification remains a topic of ongoing debate and warrants further exploration. In addition to an ongoing randomized clinical trial on oligo-recurrent NSCLC, further rigorous studies specifically addressing oligo-recurrence are needed to refine treatment strategies for this advanced yet potentially curable state. These investigations are essential for developing effective, tailored approaches to optimize outcomes for patients within this prognostically favorable subgroup.

Keywords: local ablative therapy; oligo-recurrence; radiotherapy; surgery.