Concept and definition of oligometastatic esophageal and gastroesophageal junction cancer
Koval N.O., Kolesnyk A.V., Shudrak Y.A., Dobrzhanskyi O.Y., Pepenin M.O., Turchak V.O., Horodetskyi A.V., Khudyntsev A.M., Nikolaienko V.O., Kondratskyi Y.M.
Summary. Oligometastatic esophageal and gastroesophageal junction (GEJ) cancer is considered an intermediate biological state between localized and widely metastatic disease. This condition is characterized by a limited number and distribution of metastatic lesions and a potential sensitivity to combined systemic and local treatment strategies. Over the past decade, the development of multimodal therapeutic approaches has increased clinical interest in the concept of oligometastatic disease in esophageal and GEJ cancers. The aim of this review is to summarize current evidence regarding the definition, biological features, and clinical criteria of oligometastatic esophagogastric cancer. Data from systematic reviews, retrospective cohort studies, and international expert consensus statements, including the OMEC (OligoMetastatic Esophagogastric Cancer) project, were analyzed. Contemporary definitions emphasize metastatic involvement limited to a single organ (up to three lesions) or a single extraregional lymph node station, along with disease stability following induction systemic therapy. Available evidence suggests that in carefully selected patients, local treatment modalities such as metastasectomy, ablative techniques, and stereotactic body radiotherapy may be associated with improved oncologic outcomes when integrated into multimodal treatment strategies. However, the level of evidence remains limited due to the predominance of retrospective data, selection bias, and the lack of randomized controlled trials. Prospective studies with standardized diagnostic criteria and treatment algorithms are needed to better define the role of local therapies in this clinical setting.
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