Oligometastatic Disease and Local Therapies: A Medical Oncology Perspective

Cancer J. 2020 Mar/Apr;26(2):144-148. doi: 10.1097/PPO.0000000000000439.

Abstract

Numerous studies in a variety of solid tumor malignancies have demonstrated prolonged progression-free and overall survival with the addition of definitive local therapies to systemic therapies in patients with a limited number of metastases. A subset of patients with oligometastases (1-5 metastases) may experience long-term disease remission or cure after local therapies such as surgery or stereotactic body radiation therapy to metastatic sites. This article reviews the literature in oligometastatic disease and considers a theoretical rationale for a curative approach in a subset of oligometastatic solid tumor patients. In oligometastatic colorectal cancer patients with liver-only metastases and in non-small cell lung cancer patients with disease control after primary therapy and with limited nodal involvement, aggressive local therapies should be considered. Clinical trials and further biomarker validation across disease types are necessary to clarify which subsets of patients may define a theorized "oligometastatic state" and therefore benefit from aggressive local therapies.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / analysis
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / secondary
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Clinical Trials as Topic
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery
  • Disease Progression
  • Humans
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary
  • Liver Neoplasms / therapy*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery
  • Lymph Nodes / surgery
  • Lymphatic Metastasis / diagnosis
  • Lymphatic Metastasis / therapy
  • Medical Oncology / methods*
  • Medical Oncology / trends
  • Patient Selection
  • Prognosis
  • Progression-Free Survival
  • Radiosurgery / methods
  • Radiosurgery / trends
  • Risk Assessment / methods

Substances

  • Biomarkers, Tumor