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Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe
TE. Kroese, R. van Hillegersberg, S. Schoppmann, PRAJ. Deseyne, P. Nafteux, R. Obermannova, M. Nordsmark, P. Pfeiffer, MA. Hawkins, E. Smyth, S. Markar, GB. Hanna, E. Cheong, A. Chaudry, A. Elme, A. Adenis, G. Piessen, C. Gani, CJ. Bruns, M....
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články
- MeSH
- lidé MeSH
- lymfatické uzliny MeSH
- metastázektomie * MeSH
- metastázy nádorů MeSH
- nádory * MeSH
- radiochirurgie * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
BACKGROUND: Consensus about the definition and treatment of oligometastatic oesophagogastric cancer is lacking. OBJECTIVE: To assess the definition and treatment of oligometastatic oesophagogastric cancer across multidisciplinary tumour boards (MDTs) in Europe. MATERIAL AND METHODS: European expert centers (n = 49) were requested to discuss 15 real-life cases in their MDT with at least a medical, surgical, and radiation oncologist present. The cases varied in terms of location and number of metastases, histology, timing of detection (i.e. synchronous versus metachronous), primary tumour treatment status, and response to systemic therapy. The primary outcome was the agreement in the definition of oligometastatic disease at diagnosis and after systemic therapy. The secondary outcome was the agreement in treatment strategies. Treatment strategies for oligometastatic disease were categorised into upfront local treatment (i.e. metastasectomy or stereotactic radiotherapy), systemic therapy followed by restaging to consider local treatment or systemic therapy alone. The agreement across MDTs was scored to be either absent/poor (<50%), fair (50%-75%), or consensus (≥75%). RESULTS: A total of 47 MDTs across 16 countries fully discussed the cases (96%). Oligometastatic disease was considered in patients with 1-2 metastases in either the liver, lung, retroperitoneal lymph nodes, adrenal gland, soft tissue or bone (consensus). At follow-up, oligometastatic disease was considered after a median of 18 weeks of systemic therapy when no progression or progression in size only of the oligometastatic lesion(s) was seen (consensus). If at restaging after a median of 18 weeks of systemic therapy the number of lesions progressed, this was not considered as oligometastatic disease (fair agreement). There was no consensus on treatment strategies for oligometastatic disease. CONCLUSION: A broad consensus on definitions of oligometastatic oesophagogastric cancer was found among MDTs of oesophagogastric cancer expert centres in Europe. However, high practice variability in treatment strategies exists.
Department of Medical Oncology Elisabeth Tweesteden Ziekenhuis Tilburg the Netherlands
Department of Medical Oncology Odense University Medical Center University of Odense Odense Denmark
Department of Medical Oncology Tallinn University Hospital Tallinn University Tallinn Estonia
Department of Medical Oncology University Hospital Leipzig University of Leipzig Leipzig Germany
Department of Medicine Johannes Gutenberg University Clinic University of Mainz Mainz Germany
Department of Oncology Cambridge University Hospitals Cambridge University Cambridge United Kingdom
Department of Radiation Oncology Aarhus University Medical Center Aarhus University Aarhus Denmark
Department of Radiation Oncology Ghent University Hospital Ghent Belgium
Department of Radiation Oncology Netherlands Cancer Institute Amsterdam the Netherlands
Department of Radiation Oncology Radboud University Medical Center Nijmegen the Netherlands
Department of Radiation Oncology University Hospital Bologna Bologna Italy
Department of Radiation Oncology University Hospital Zurich University of Zurich Zurich Switzerland
Department of Surgery Antoni van Leeuwenhoek Netherlands Cancer Institute Amsterdam the Netherlands
Department of Surgery Catharina Medical Center Eindhoven the Netherlands
Department of Surgery Fondazione Policlinico Universitario Agostino Gemelli Rome Italy
Department of Surgery Geneva University Hospitals University of Geneva Geneva Switzerland
Department of Surgery Humanitas University Medical Center Humanitas University Milan Italy
Department of Surgery Imperial College London London University London United Kingdom
Department of Surgery Jagiellonian University Medical College Krakow Poland
Department of Surgery KU Leuven Leuven University Leuven Belgium
Department of Surgery Medical University of Vienna Vienna University Vienna Austria
Department of Surgery Royal Marsden Hospital London University London United Kingdom
Department of Surgery San Raffaele Hospital San Raffaele Vita salute University Milan Italy
Department of Surgery Siena University Hospital University of Siena Siena Italy
Department of Surgery St James Hospital Trinity College Dublin Dublin Ireland
Department of Surgery University Hospital C Huriez Lille University Lille France
Department of Surgery University Hospital Cologne University of Cologne Cologne Germany
Department of Surgery University Hospital Verona University of Vero Verona Italy
Department of Surgery University of Athens Medical School University of Athens Athens Greece
Department of Surgery Utrecht University Medical Center Utrecht University Utrecht the Netherlands
Department of Surgical Oncology Medical University of Lublin Lublin Poland
Medical Physics and Biomedical Engineering University College London London United Kingdom
Citace poskytuje Crossref.org
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- $a Kroese, Tiuri E $u Department of Surgery, Utrecht University Medical Center, Utrecht University, Utrecht, the Netherlands; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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- $a BACKGROUND: Consensus about the definition and treatment of oligometastatic oesophagogastric cancer is lacking. OBJECTIVE: To assess the definition and treatment of oligometastatic oesophagogastric cancer across multidisciplinary tumour boards (MDTs) in Europe. MATERIAL AND METHODS: European expert centers (n = 49) were requested to discuss 15 real-life cases in their MDT with at least a medical, surgical, and radiation oncologist present. The cases varied in terms of location and number of metastases, histology, timing of detection (i.e. synchronous versus metachronous), primary tumour treatment status, and response to systemic therapy. The primary outcome was the agreement in the definition of oligometastatic disease at diagnosis and after systemic therapy. The secondary outcome was the agreement in treatment strategies. Treatment strategies for oligometastatic disease were categorised into upfront local treatment (i.e. metastasectomy or stereotactic radiotherapy), systemic therapy followed by restaging to consider local treatment or systemic therapy alone. The agreement across MDTs was scored to be either absent/poor (<50%), fair (50%-75%), or consensus (≥75%). RESULTS: A total of 47 MDTs across 16 countries fully discussed the cases (96%). Oligometastatic disease was considered in patients with 1-2 metastases in either the liver, lung, retroperitoneal lymph nodes, adrenal gland, soft tissue or bone (consensus). At follow-up, oligometastatic disease was considered after a median of 18 weeks of systemic therapy when no progression or progression in size only of the oligometastatic lesion(s) was seen (consensus). If at restaging after a median of 18 weeks of systemic therapy the number of lesions progressed, this was not considered as oligometastatic disease (fair agreement). There was no consensus on treatment strategies for oligometastatic disease. CONCLUSION: A broad consensus on definitions of oligometastatic oesophagogastric cancer was found among MDTs of oesophagogastric cancer expert centres in Europe. However, high practice variability in treatment strategies exists.
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