Systematic Reviews
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2019; 11(9): 741-749
Published online Sep 15, 2019. doi: 10.4251/wjgo.v11.i9.741
Detection and management of oligometastatic disease in oesophageal cancer and identification of prognostic factors: A systematic review
Sara Jamel, Karina Tukanova, Sheraz Markar
Sara Jamel, Karina Tukanova, Sheraz Markar, Department Surgery and Cancer, Imperial College London, London W2 1NY, United Kingdom
Author contributions: Jamel S, Tukanova K and Markar M contributed equally to this work; Jamel S, Tukanova K and Markar M designed the study; Jamel S and Tukanova K performed the search and checked articles for inclusion; All authors contributed to the analytical tools used and analysed the data, wrote the manuscript and have read and approved the final manuscript.
Conflict-of-interest statement: The authors declared no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Sheraz R Markar, PhD, Surgeon, Division of Surgery, Department of Surgery and Cancer, Imperial College London, 10th Floor QEQM Building, St Mary’s Hospital, South Wharf Road, London W2 1NY, United Kingdom. s.markar@imperial.ac.uk
Telephone: +44-207-8862125 Fax: +44-207-8862125
Received: February 20, 2019
Peer-review started: February 22, 2019
First decision: June 5, 2019
Revised: June 25, 2019
Accepted: July 29, 2019
Article in press: July 29, 2019
Published online: September 15, 2019
Abstract
BACKGROUND

Oesophageal cancer is the eighth most common cancer worldwide. The prognosis of oesophageal cancer patients still remains poor. The 5-year survival rate rarely exceeds 5% in case of metastatic disease. Some patients may however present with oligometastasis which can be treated with loco-regional therapy.

AIM

To assess the current practice regarding the management of patients with oligometastatic oesophageal cancer and identify prognostic factors affecting survival following treatment for oligometastasis.

METHODS

A systematic search of the literature was performed in Cochrance Library, MEDLINE and EMBASE databases from September 1950 to January 2019. Relevant electronic databases were searched for studies assessing the clinical outcome of oligometastasis.

RESULTS

A total of 14 publications were included, of which 12 studies assessing metachronous oligometastasis and 2 on synchronous oligometastasis. All included articles evaluated the specific outcomes of metastasis, management modality and survival outcomes. The majority of the patients presented with oesophageal squamous cell carcinoma. The median disease free interval (time to recurrence) in patients was 19.6 mo and the overall survival reached 30.8 months. Unfavourable prognostic factors were assessed in eight studies and included time to recurrence < 12 mo, large diameter pulmonary lesions (> 20 mm), disease free interval (DFI) < 12 mo, extra-pulmonary metastasis, primary tumour pathological stage III/IV.

CONCLUSION

Oligometastatic oesophageal cancer in selected patients is amenable to loco-regional treatment, and the overall survival of this patient cohort may be improved with patient and tumour-specific treatments.

Keywords: Oligometastasis, Oesophageal cancer, Neoplasm, Liver, Pulmonary

Core tip: Oesophageal cancer often presents with early metastatic spread, which carries a poor prognosis. Some patients may have limited metastatic disease that can be treated with loco-regional therapy. The guidelines for the management of oligometastasis in oesophageal cancer are however not clearly established and survival outcomes remain unclear. The aims of this review were to assess the current practice for the treatment of oligometastatic oesophageal cancer and factors affecting survival following treatment of oligometastasis. A total of 14 publications were included assessing the management and survival outcomes and the majority of these studies opted for aggressive treatment in appropriate patient selection.