The new effective systemic treatment strategy has "created" many long-term stage Ⅳ non-small cell lung cancer (NSCLC) survivors, and surgeons should pay attention to those individual ineffective lesions of long-term survivors. Besides, the new effective systemic treatment strategy may have changed the original concept and population of oligometasis. To intervene the oligo-progression lesions of long-term stage Ⅳ survivors, particularly after effective systemic treatment, at appropriate time with appropriate way might be the main task of surgery in the future.
Local treatment improves the outcomes for oligometastatic disease, an intermediate state between locoregional and widespread disease. However, consensus about the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer is lacking. The first edition "Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe" was published on February 15, 2023 by 65 European medical specialists. In this article, the consensus will be interpreted to provide new idea for the diagnosis and treatment of oligometastatic oesophagogastric cancer for Chinese clinicians.
In recent years, with the clinical application of minimally invasive surgical techniques and comprehensive perioperative treatment, the survival rate of locally advanced esophageal cancer has significantly improved. However, the treatment of metastatic esophagogastric cancer still relies mainly on systemic therapy, and immunotherapy combined with chemotherapy has become a first-line treatment option, prolonging the survival of patients with metastatic esophagal cancer. Oligometastatic esophagal cancer is expected to bring survival benefits through systemic therapy combined with local treatment. The 2024 European clinical practice guidelines for oligometastatic esophageal and gastric cancer have been officially released, which standardize the definition, diagnosis, and treatment of oligometastatic esophageal cancer for further prospective studies. The author interprets this guideline, especially by reviewing the clinical evidence of oligometastatic esophageal squamous cell carcinoma, to provide reference for the diagnosis and treatment of oligometastatic esophageal cancer in China.