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Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe
TE. Kroese, HWM. van Laarhoven, SF. Schoppman, PRAJ. Deseyne, E. van Cutsem, K. Haustermans, P. Nafteux, M. Thomas, R. Obermannova, HR. Mortensen, M. Nordsmark, P. Pfeiffer, A. Elme, A. Adenis, G. Piessen, CJ. Bruns, F. Lordick, I. Gockel, M....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu systematický přehled, časopisecké články
- MeSH
- delfská metoda MeSH
- lidé MeSH
- nádory * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
- Geografické názvy
- Evropa MeSH
BACKGROUND: Local treatment improves the outcomes for oligometastatic disease (OMD, i.e. an intermediate state between locoregional and widespread disseminated disease). However, consensus about the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer is lacking. The aim of this study was to develop a multidisciplinary European consensus statement on the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer. METHODS: In total, 65 specialists in the multidisciplinary treatment for oesophagogastric cancer from 49 expert centres across 16 European countries were requested to participate in this Delphi study. The consensus finding process consisted of a starting meeting, 2 online Delphi questionnaire rounds and an online consensus meeting. Input for Delphi questionnaires consisted of (1) a systematic review on definitions of oligometastatic oesophagogastric cancer and (2) a discussion of real-life clinical cases by multidisciplinary teams. Experts were asked to score each statement on a 5-point Likert scale. The agreement was scored to be either absent/poor (<50%), fair (50%-75%) or consensus (≥75%). RESULTS: A total of 48 experts participated in the starting meeting, both Delphi rounds, and the consensus meeting (overall response rate: 71%). OMD was considered in patients with metastatic oesophagogastric cancer limited to 1 organ with ≤3 metastases or 1 extra-regional lymph node station (consensus). In addition, OMD was considered in patients without progression at restaging after systemic therapy (consensus). For patients with synchronous or metachronous OMD with a disease-free interval ≤2 years, systemic therapy followed by restaging to consider local treatment was considered as treatment (consensus). For metachronous OMD with a disease-free interval >2 years, either upfront local treatment or systemic treatment followed by restaging was considered as treatment (fair agreement). CONCLUSION: The OMEC project has resulted in a multidisciplinary European consensus statement for the definition, diagnosis and treatment of oligometastatic oesophagogastric adenocarcinoma and squamous cell cancer. This can be used to standardise inclusion criteria for future clinical trials.
Cancer Center Amsterdam Cancer Treatment and Quality of Life Amsterdam the Netherlands
Danish Center of Particle Therapy Aarhus University Medical Center Aarhus University Aarhus Denmark
Department of GI Surgery San Raffaele Hospital San Raffaele Vita salute University Milan Italy
Department of Medical Oncology Catharina Medical Center Eindhoven the Netherlands
Department of Medical Oncology Elisabeth Tweesteden Ziekenhuis Tilburg the Netherlands
Department of Medical Oncology IRCM Inserm Université Montpellier ICM Montpellier France
Department of Medical Oncology KU Leuven Leuven University Leuven Belgium
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 and Radiotherapy Maria Skłodowska Curie Institute Warsaw Poland
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 AZ Sint Maarten Mechelen Belgium
Department of Radiation Oncology Catharina Medical Center Eindhoven the Netherlands
Department of Radiation Oncology DIMES Alma Mater Studiorum Bologna University Bologna Italy
Department of Radiation Oncology Ghent University Hospital Ghent Belgium
Department of Radiation Oncology IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy
Department of Radiation Oncology KU Leuven Leuven University Leuven Belgium
Department of Radiation Oncology Radboud University Medical Center Nijmegen the Netherlands
Department of Radiation Oncology Radiotherapiegroep Deventer the Netherlands
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 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 School National and Kapodistrian University of Athens Athens Greece
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 Siena University Hospital University of Siena Siena Italy
Department of Surgery St James Hospital Trinity College Dublin Dublin Ireland
Department of Surgery University Hospital Cologne University of Cologne Cologne Germany
Department of Surgery University Hospital Geneva University of Geneva Geneva Switzerland
Department of Surgery University Medical Center Leiden University of Leiden Leiden the Netherlands
Department of Surgery University Medical Center Utrecht Utrecht University Utrecht the Netherlands
Department of Surgical Oncology Medical University of Lublin Lublin Poland
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- $a Kroese, Tiuri E $u Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. Electronic address: https://twitter.com/TEKroese
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- $a Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe / $c TE. Kroese, HWM. van Laarhoven, SF. Schoppman, PRAJ. Deseyne, E. van Cutsem, K. Haustermans, P. Nafteux, M. Thomas, R. Obermannova, HR. Mortensen, M. Nordsmark, P. Pfeiffer, A. Elme, A. Adenis, G. Piessen, CJ. Bruns, F. Lordick, I. Gockel, M. Moehler, C. Gani, T. Liakakos, J. Reynolds, AG. Morganti, R. Rosati, C. Castoro, F. Cellini, D. D'Ugo, F. Roviello, M. Bencivenga, G. de Manzoni, MI. van Berge Henegouwen, MCCM. Hulshof, J. van Dieren, M. Vollebergh, JW. van Sandick, P. Jeene, CT. Muijs, M. Slingerland, FEM. Voncken, H. Hartgrink, GJ. Creemers, MJC. van der Sangen, G. Nieuwenhuijzen, M. Berbee, M. Verheij, B. Wijnhoven, LV. Beerepoot, NH. Mohammad, S. Mook, JP. Ruurda, P. Kolodziejczyk, WP. Polkowski, L. Wyrwicz, M. Alsina, M. Pera, TF. Kanonnikoff, A. Cervantes, M. Nilsson, S. Monig, AD. Wagner, M. Guckenberger, EA. Griffiths, E. Smyth, GB. Hanna, S. Markar, MA. Chaudry, MA. Hawkins, E. Cheong, R. van Hillegersberg, PSN. van Rossum, OMEC collaborators
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- $a BACKGROUND: Local treatment improves the outcomes for oligometastatic disease (OMD, i.e. an intermediate state between locoregional and widespread disseminated disease). However, consensus about the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer is lacking. The aim of this study was to develop a multidisciplinary European consensus statement on the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer. METHODS: In total, 65 specialists in the multidisciplinary treatment for oesophagogastric cancer from 49 expert centres across 16 European countries were requested to participate in this Delphi study. The consensus finding process consisted of a starting meeting, 2 online Delphi questionnaire rounds and an online consensus meeting. Input for Delphi questionnaires consisted of (1) a systematic review on definitions of oligometastatic oesophagogastric cancer and (2) a discussion of real-life clinical cases by multidisciplinary teams. Experts were asked to score each statement on a 5-point Likert scale. The agreement was scored to be either absent/poor (<50%), fair (50%-75%) or consensus (≥75%). RESULTS: A total of 48 experts participated in the starting meeting, both Delphi rounds, and the consensus meeting (overall response rate: 71%). OMD was considered in patients with metastatic oesophagogastric cancer limited to 1 organ with ≤3 metastases or 1 extra-regional lymph node station (consensus). In addition, OMD was considered in patients without progression at restaging after systemic therapy (consensus). For patients with synchronous or metachronous OMD with a disease-free interval ≤2 years, systemic therapy followed by restaging to consider local treatment was considered as treatment (consensus). For metachronous OMD with a disease-free interval >2 years, either upfront local treatment or systemic treatment followed by restaging was considered as treatment (fair agreement). CONCLUSION: The OMEC project has resulted in a multidisciplinary European consensus statement for the definition, diagnosis and treatment of oligometastatic oesophagogastric adenocarcinoma and squamous cell cancer. This can be used to standardise inclusion criteria for future clinical trials.
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