# Oligometastatic disease in esophagogastric cancer: an update of recommendations on definition, diagnosis, and treatment

## TL;DR

This paper updates guidelines for defining and treating oligometastatic esophagogastric cancer, focusing on a multidisciplinary consensus and treatment strategies.

## Contribution

The paper introduces a multidisciplinary European consensus on defining and treating oligometastatic esophagogastric cancer.

## Key findings

- A consensus definition includes one organ with ≤3 metastases or one extra-regional lymph node station as oligometastatic disease.
- Systemic therapy followed by restaging is recommended for patients with oligometastatic disease.
- Local treatment is advised for patients without progression at 18F-FDG PET/CT restaging.

## Abstract

Oligometastatic cancer is characterized by the presence of a restricted number of metastatic lesions extending beyond the primary tumor. Until recently, there was a significant lack of agreement concerning the precise definition and optimal treatment strategies for oligometastatic cancer in the context of esophageal or gastric malignancies. Here we provide an overview of the OligoMetastatic Esophagogastric Cancer (OMEC) project which was initiated to develop a multidisciplinary European consensus statement for the definition, diagnosis, and treatment of oligometastatic esophagogastric cancer. Additionally, we provide an updated systematic review of published and ongoing clinical studies on local metastasis-directed treatment of oligometastatic esophagogastric cancer.

•A multidisciplinary consensus definition for esophagogastric OMD was developed.•One organ with ≤3 metastases is considered OMD.•One extra-regional lymph node station is considered OMD.•Patients with OMD undergo systemic therapy followed by restaging.•Patients without progression at 18F-FDG PET/CT restaging undergo local treatment.

A multidisciplinary consensus definition for esophagogastric OMD was developed.

One organ with ≤3 metastases is considered OMD.

One extra-regional lymph node station is considered OMD.

Patients with OMD undergo systemic therapy followed by restaging.

Patients without progression at 18F-FDG PET/CT restaging undergo local treatment.