OGC P06 Oncological outcomes of patients with oligometastatic oesophagogastric cancer

Abstract

Abstract Background A recent international expert consensus defined oligometastatic oesophagogastric cancer as the presence of no more than two liver, lung, retroperitoneal lymph node, adrenal, soft tissue or bone metastases and an 18-week period of oncological stability during chemotherapy. The number of patients who fit this criterion and whether their oncological outcome differs from those with multi-metastatic disease is unknown. Methods We analysed our prospectively maintained database of consecutive patients with synchronous or metachronous metastatic oesophagogastric cancer from January 2017 to December 2021. The primary outcome was median overall survival (OS). Results We included 502 patients with 120 patients (24%) metachronous metastases following surgical resection of primary tumour and 382 (76%) with synchronous metastases. 36 (7.2%) had oligometastatic disease. For patients with metastases at diagnosis, median OS was 7.3 months for the multi-metastatic group versus 26.8 months for patients with oligometastasis(p<0.0001). For metachronous disease, median OS in multi-metastatic groups was 6.1 months versus 38.6 months for patients with oligometastasis(p<0.0001). 35% of patients with metachronous oligometastatic disease underwent surgical management of their metastasis. This group demonstrated improved median OS versus those receiving systemic treatment alone (>60 months versus 24.4 months; p<0.038). Conclusions Oligometastatic oesophagogastric cancer is associated with improved oncological outcome when compared to multi-metastatic disease. Further work is needed to identify patients who will benefit from aggressive treatment of metastatic oesophagogastric cancer.