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1. Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe

Author

Kroese, T.E. van Laarhoven, H.W.M. Schoppman, S.F. Deseyne, P.R.A.J. van Cutsem, E. Haustermans, K. Nafteux, P. Thomas, M. Obermannova, R. Mortensen, H.R. Nordsmark, M. Pfeiffer, P. Elme, A. Adenis, A. Piessen, G. Bruns, C.J. Lordick, F. Gockel, I. Moehler, M. Gani, C. Liakakos, T. Reynolds, J. Morganti, A.G. Rosati, R. Castoro, C. Cellini, F. D'Ugo, D. Roviello, F. Bencivenga, M. de Manzoni, G. van Berge Henegouwen, M.I. Hulshof, M.C.C.M. van Dieren, J. Vollebergh, M. van Sandick, J.W. Jeene, P. Muijs, C.T. Slingerland, M. Voncken, F.E.M. Hartgrink, H. Creemers, G.-J. van der Sangen, M.J.C. Nieuwenhuijzen, G. Berbee, M. Verheij, M. Wijnhoven, B. Beerepoot, L.V. Mohammad, N.H. Mook, S. Ruurda, J.P. Kolodziejczyk, P. Polkowski, W.P. Wyrwicz, L. Alsina, M. Pera, M. Kanonnikoff, T.F. Cervantes, A. Nilsson, M. Monig, S. Wagner, A.D. Guckenberger, M. Griffiths, E.A. Smyth, E. Hanna, G.B. Markar, S. Chaudry, M.A. Hawkins, M.A. Cheong, E. van Hillegersberg, R. van Rossum, P.S.N. Rozema, T. Heisterkamp, J. Schaefer, M. Ozsahin, E.-M. de Haan, J. Willem van den Berg, J. Duprez, F. Callebout, E. van Daele, E. Hacker, U. Hoffmeister, A. Kuhnt, T. Denecke, T. Kluge, R. Prager, G. Ilhan-Mutlu, A. Cuicchi, D. Ardizzoni, A. Rosman, C. Gootjes, E.C. Rütten, H. Puccetti, F. Cascinu, S. Slim, N. Barrios, M.E. Fernandez, M.C. Martí-Oriol, R. Alvaro, M.H. Vera, A. Jordá, E. Mozos, F.L. Reig, A. Visa, L. Ciseł, B. Czechowska, J. Kwietniewska, M. Pikuła, A. Skórzewska, M. Kozłowska, A. Rawicz-Pruszyński, K. the OMEC collaborators and Kroese, T.E. van Laarhoven, H.W.M. Schoppman, S.F. Deseyne, P.R.A.J. van Cutsem, E. Haustermans, K. Nafteux, P. Thomas, M. Obermannova, R. Mortensen, H.R. Nordsmark, M. Pfeiffer, P. Elme, A. Adenis, A. Piessen, G. Bruns, C.J. Lordick, F. Gockel, I. Moehler, M. Gani, C. Liakakos, T. Reynolds, J. Morganti, A.G. Rosati, R. Castoro, C. Cellini, F. D'Ugo, D. Roviello, F. Bencivenga, M. de Manzoni, G. van Berge Henegouwen, M.I. Hulshof, M.C.C.M. van Dieren, J. Vollebergh, M. van Sandick, J.W. Jeene, P. Muijs, C.T. Slingerland, M. Voncken, F.E.M. Hartgrink, H. Creemers, G.-J. van der Sangen, M.J.C. Nieuwenhuijzen, G. Berbee, M. Verheij, M. Wijnhoven, B. Beerepoot, L.V. Mohammad, N.H. Mook, S. Ruurda, J.P. Kolodziejczyk, P. Polkowski, W.P. Wyrwicz, L. Alsina, M. Pera, M. Kanonnikoff, T.F. Cervantes, A. Nilsson, M. Monig, S. Wagner, A.D. Guckenberger, M. Griffiths, E.A. Smyth, E. Hanna, G.B. Markar, S. Chaudry, M.A. Hawkins, M.A. Cheong, E. van Hillegersberg, R. van Rossum, P.S.N. Rozema, T. Heisterkamp, J. Schaefer, M. Ozsahin, E.-M. de Haan, J. Willem van den Berg, J. Duprez, F. Callebout, E. van Daele, E. Hacker, U. Hoffmeister, A. Kuhnt, T. Denecke, T. Kluge, R. Prager, G. Ilhan-Mutlu, A. Cuicchi, D. Ardizzoni, A. Rosman, C. Gootjes, E.C. Rütten, H. Puccetti, F. Cascinu, S. Slim, N. Barrios, M.E. Fernandez, M.C. Martí-Oriol, R. Alvaro, M.H. Vera, A. Jordá, E. Mozos, F.L. Reig, A. Visa, L. Ciseł, B. Czechowska, J. Kwietniewska, M. Pikuła, A. Skórzewska, M. Kozłowska, A. Rawicz-Pruszyński, K. the OMEC collaborators

Abstract

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

Published
2023

2. Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe

Author

Kroese, T.E., Laarhoven, H.W.M. van, Schoppman, S.F., Deseyne, P., Cutsem, E. Van, Haustermans, K., Nafteux, P., Thomas, M., Obermannova, R., Mortensen, H.R., Nordsmark, M., Pfeiffer, P., Elme, A., Adenis, A., Piessen, G., Bruns, C.J., Lordick, F., Gockel, I., Moehler, M., Gani, C., Liakakos, T., Reynolds, J., Morganti, A.G., Rosati, R., Castoro, C., Cellini, F., D'Ugo, D., Roviello, F., Bencivenga, M., Manzoni, G. de, Henegouwen, M.I. van Berge, Hulshof, M., Dieren, J. van, Vollebergh, M., Sandick, J.W. van, Jeene, P., Muijs, C.T., Slingerland, M., Voncken, F.E.M., Hartgrink, H., Creemers, G.J., Sangen, M.J. van der, Nieuwenhuijzen, G., Berbee, M., Verheij, M., Wijnhoven, B., Beerepoot, L.V., Mohammad, N.H., Mook, S., Ruurda, J.P., Kolodziejczyk, P., Polkowski, W.P., Wyrwicz, L., Alsina, M., Pera, M., Kanonnikoff, T.F., Cervantes, A., Nilsson, M., Monig, S., Wagner, A.D., Guckenberger, M., Griffiths, E.A., Smyth, E., Hanna, G.B., Markar, S., Chaudry, M.A., Hawkins, M.A., Cheong, E., Rütten, H., Gootjes, E.C., Hillegersberg, R. van, Rossum, P.S.N. van, Kroese, T.E., Laarhoven, H.W.M. van, Schoppman, S.F., Deseyne, P., Cutsem, E. Van, Haustermans, K., Nafteux, P., Thomas, M., Obermannova, R., Mortensen, H.R., Nordsmark, M., Pfeiffer, P., Elme, A., Adenis, A., Piessen, G., Bruns, C.J., Lordick, F., Gockel, I., Moehler, M., Gani, C., Liakakos, T., Reynolds, J., Morganti, A.G., Rosati, R., Castoro, C., Cellini, F., D'Ugo, D., Roviello, F., Bencivenga, M., Manzoni, G. de, Henegouwen, M.I. van Berge, Hulshof, M., Dieren, J. van, Vollebergh, M., Sandick, J.W. van, Jeene, P., Muijs, C.T., Slingerland, M., Voncken, F.E.M., Hartgrink, H., Creemers, G.J., Sangen, M.J. van der, Nieuwenhuijzen, G., Berbee, M., Verheij, M., Wijnhoven, B., Beerepoot, L.V., Mohammad, N.H., Mook, S., Ruurda, J.P., Kolodziejczyk, P., Polkowski, W.P., Wyrwicz, L., Alsina, M., Pera, M., Kanonnikoff, T.F., Cervantes, A., Nilsson, M., Monig, S., Wagner, A.D., Guckenberger, M., Griffiths, E.A., Smyth, E., Hanna, G.B., Markar, S., Chaudry, M.A., Hawkins, M.A., Cheong, E., Rütten, H., Gootjes, E.C., Hillegersberg, R. van, and Rossum, P.S.N. van

Abstract

Item does not contain fulltext, 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 resul

Published
2023

3. Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe

Author

Kroese, T.E. van Hillegersberg, R. Schoppmann, S. Deseyne, P.R.A.J. Nafteux, P. Obermannova, R. Nordsmark, M. Pfeiffer, P. Hawkings, M.A. Smyth, E. Markar, S. Hanna, G.B. Cheong, E. Chaudry, A. Elme, A. Adenis, A. Piessen, G. Gani, C. Bruns, C.J. Moehler, M. Liakakos, T. Reynolds, J. Morganti, A. Rosati, R. Castoro, C. D'Ugo, D. Roviello, F. Bencivenga, M. de Manzoni, G. Jeene, P. van Sandick, J.W. Muijs, C. Slingerland, M. Nieuwenhuijzen, G. Wijnhoven, B. Beerepoot, L.V. Kolodziejczyk, P. Polkowski, W.P. Alsina, M. Pera, M. Kanonnikoff, T.F. Nilsson, M. Guckenberger, M. Monig, S. Wagner, D. Wyrwicz, L. Berbee, M. Gockel, I. Lordick, F. Griffiths, E.A. Verheij, M. van Rossum, P.S.N. van Laarhoven, H.W.M. Rosman, C. Rütten, H. Gootjes, E.C. Vonken, F.E.M. van Dieren, J.M. Vollebergh, M.A. van der Sangen, M. Creemers, G.-J. Zander, T. Schlößer, H. Cascinu, S. Mazza, E. Nicoletti, R. Damascelli, A. Slim, N. Passoni, P. Cossu, A. Puccetti, F. Barbieri, L. Fanti, L. Azzolini, F. Ventoruzzo, F. Szczepanik, A. Visa, L. Reig, A. Roques, T. Harrison, M. Ciseł, B. Pikuła, A. Skórzewska, M. Vanommeslaeghe, H. Van Daele, E. Pattyn, P. Geboes, K. Callebout, E. Ribeiro, S. van Duijvendijk, P. Tromp, C. Sosef, M. Warmerdam, F. Heisterkamp, J. Vera, A. Jordá, E. López-Mozos, F. Fernandez-Moreno, M.C. Barrios-Carvajal, M. Huerta, M. de Steur, W. Lips, I. Diez, M. Castro, S. O'Neill, R. Holyoake, D. Hacker, U. Denecke, T. Kuhnt, T. Hoffmeister, A. Kluge, R. Bostel, T. Grimminger, P. Jedlička, V. Křístek, J. Pospíšil, P. Mourregot, A. Maurin, C. Starling, N. Chong, I. OMEC working group and Kroese, T.E. van Hillegersberg, R. Schoppmann, S. Deseyne, P.R.A.J. Nafteux, P. Obermannova, R. Nordsmark, M. Pfeiffer, P. Hawkings, M.A. Smyth, E. Markar, S. Hanna, G.B. Cheong, E. Chaudry, A. Elme, A. Adenis, A. Piessen, G. Gani, C. Bruns, C.J. Moehler, M. Liakakos, T. Reynolds, J. Morganti, A. Rosati, R. Castoro, C. D'Ugo, D. Roviello, F. Bencivenga, M. de Manzoni, G. Jeene, P. van Sandick, J.W. Muijs, C. Slingerland, M. Nieuwenhuijzen, G. Wijnhoven, B. Beerepoot, L.V. Kolodziejczyk, P. Polkowski, W.P. Alsina, M. Pera, M. Kanonnikoff, T.F. Nilsson, M. Guckenberger, M. Monig, S. Wagner, D. Wyrwicz, L. Berbee, M. Gockel, I. Lordick, F. Griffiths, E.A. Verheij, M. van Rossum, P.S.N. van Laarhoven, H.W.M. Rosman, C. Rütten, H. Gootjes, E.C. Vonken, F.E.M. van Dieren, J.M. Vollebergh, M.A. van der Sangen, M. Creemers, G.-J. Zander, T. Schlößer, H. Cascinu, S. Mazza, E. Nicoletti, R. Damascelli, A. Slim, N. Passoni, P. Cossu, A. Puccetti, F. Barbieri, L. Fanti, L. Azzolini, F. Ventoruzzo, F. Szczepanik, A. Visa, L. Reig, A. Roques, T. Harrison, M. Ciseł, B. Pikuła, A. Skórzewska, M. Vanommeslaeghe, H. Van Daele, E. Pattyn, P. Geboes, K. Callebout, E. Ribeiro, S. van Duijvendijk, P. Tromp, C. Sosef, M. Warmerdam, F. Heisterkamp, J. Vera, A. Jordá, E. López-Mozos, F. Fernandez-Moreno, M.C. Barrios-Carvajal, M. Huerta, M. de Steur, W. Lips, I. Diez, M. Castro, S. O'Neill, R. Holyoake, D. Hacker, U. Denecke, T. Kuhnt, T. Hoffmeister, A. Kluge, R. Bostel, T. Grimminger, P. Jedlička, V. Křístek, J. Pospíšil, P. Mourregot, A. Maurin, C. Starling, N. Chong, I. OMEC working group

Abstract

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 o

Published
2022

4. Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe

Author

Kroese, T.E., Hillegersberg, R. van, Schoppmann, S., Deseyne, P., Nafteux, P., Obermannova, R., Nordsmark, M., Pfeiffer, P., Hawkins, M.A., Smyth, E., Markar, S., Hanna, G.B., Cheong, E., Chaudry, A., Elme, A., Adenis, A., Piessen, G., Gani, C., Bruns, C.J., Moehler, M., Liakakos, T., Reynolds, J., Morganti, A., Rosati, R., Castoro, C., D'Ugo, D., Roviello, F., Bencivenga, M., Manzoni, G. de, Jeene, P., Sandick, J.W. van, Muijs, C., Slingerland, M., Nieuwenhuijzen, G., Wijnhoven, B., Beerepoot, L.V., Kolodziejczyk, P., Polkowski, W.P., Alsina, M., Pera, M., Kanonnikoff, T.F., Nilsson, M., Guckenberger, M., Monig, S., Wagner, D., Wyrwicz, L., Berbee, M., Gockel, I., Lordick, F., Griffiths, E.A., Rütten, H., Rosman, C., Verheij, M., Rossum, P.S.N. van, Laarhoven, H.W. van, Kroese, T.E., Hillegersberg, R. van, Schoppmann, S., Deseyne, P., Nafteux, P., Obermannova, R., Nordsmark, M., Pfeiffer, P., Hawkins, M.A., Smyth, E., Markar, S., Hanna, G.B., Cheong, E., Chaudry, A., Elme, A., Adenis, A., Piessen, G., Gani, C., Bruns, C.J., Moehler, M., Liakakos, T., Reynolds, J., Morganti, A., Rosati, R., Castoro, C., D'Ugo, D., Roviello, F., Bencivenga, M., Manzoni, G. de, Jeene, P., Sandick, J.W. van, Muijs, C., Slingerland, M., Nieuwenhuijzen, G., Wijnhoven, B., Beerepoot, L.V., Kolodziejczyk, P., Polkowski, W.P., Alsina, M., Pera, M., Kanonnikoff, T.F., Nilsson, M., Guckenberger, M., Monig, S., Wagner, D., Wyrwicz, L., Berbee, M., Gockel, I., Lordick, F., Griffiths, E.A., Rütten, H., Rosman, C., Verheij, M., Rossum, P.S.N. van, and Laarhoven, H.W. van

Abstract

Item does not contain fulltext, 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 oeso

Published
2022

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