• Eur. J. Cancer · Dec 2019

    Defining oligometastatic non-small cell lung cancer: A simulated multidisciplinary expert opinion.

    • Lizza E L Hendriks, Christophe Dooms, Thierry Berghmans, Silvia Novello, Antonin Levy, Dirk De Ruysscher, Baktiar Hasan, Giaj Levra Matteo M Young Investigators EORTC Lung Cancer Group (YI EORTC LCG), Belgium; Respiratory Oncology Unit, Department of Thoracic and Vascular Disease, CHU Greno, Niccolo Giaj Levra, Benjamin Besse, Johan Vansteenkiste, Dingemans Anne-Marie C AC Department of Pulmonary Diseases, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the N, and European Organisation for Research and Treatment of Cancer (EORTC) Lung Cancer Group.
    • Department of Pulmonary Diseases, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands; Young Investigators EORTC Lung Cancer Group (YI EORTC LCG), Belgium. Electronic address: lizza.hendriks@mumc.nl.
    • Eur. J. Cancer. 2019 Dec 1; 123: 28-35.

    IntroductionSynchronous oligometastatic non-small cell lung cancer (NSCLC) definition varies from 1 metastasis in 1 organ (tumour-node-metastasis 8 [TNM8]), 1-3 metastases (European Society for Medical Oncology [ESMO]), ≤3 metastases (including mediastinal nodes [MLN]) after systemic treatment to 3-5 metastases in ongoing trials. A single definition is however needed to design/compare trials. To assess oligometastatic NSCLC definitions used by clinical experts in daily practice and its evolution, we redistributed a 2012 case-based survey (Dooms, the World Congress of Lung Cancer 2013).MethodsIn December 2017, 10 real-life multidisciplinary team (MDT) discussed patients (good condition, no significant comorbidities, 18F-fluorodeoxyglucose positron emission tomography/brain magnetic resonance imaging staged, all < 5 metastases, 9/10 ≤ 3 metastases, oncogene-addicted or wild-type) were distributed to 33 international NSCLC experts involved in the European Organisation for Research and Treatment of Cancer oligometastatic NSCLC consensus group, questioning is this oligometastatic disease and if oligometastatic, which treatment proposal. The answers provided in 2017 were compared with the 2012 answers; real-life treatment and survival of the patients was added.ResultsTwenty-six of 33 experts (24 centres) replied: 8 medical oncologists, 7 pulmonologists, 7 radiation oncologists, 4 thoracic surgeons. Sixty-two percent of respondents discussed the cases with their MDT. One case had 100% oligometastatic consensus, and 3 cases had >90% consensus; the number of treatment proposals varied between 3 and 8. Radical treatment was more often offered in case of single metastasis or N0. Compared with 2012, there was a trend towards a more conservative oligometastatic definition and chemotherapy was more frequently included in the treatment proposal.ConclusionsOligometastatic NSCLC definition was conservative. The number of organs, MLN status and radical treatment possibility seem to be components of daily practice oligometastatic definition.Copyright © 2019 Elsevier Ltd. All rights reserved.

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