Publication:

Approach of oligometastatic cancer with intent of cure- exploring the road to recovery: interim analysis

Oligometastases is a disease concept that is a state of limited systemic metastatic tumors defined in most studies as 1-3 or 1-5 metastatic lesions for which local therapy could be curative. Oligometastatic cancer has been traditionally managed by systemic therapy. With the hypothesis that not only long-term disease control, but also cure can be achieved in at least in a proportion of such patients, we analysed whether aggressive multimodality approach could become a new standard of care in highly selected patients with oligometastatic cancer. It is a case series of potentially curable oligometastatic cancers in our Institution approached with cure directed ablative/surgical procedures. An interim analysis was done after completion of all modalities of treatment and the outcomes analysed were local control/cure and disease-free survival. 15 patients were treated with curative intent which included eleven breast cancer and one each of gastric, OG junction, oesophagus, and rectal cancer. Metastases were treated with surgery in seven patients. Four patients were treated with SBRT, and EBRT was used in three other patients to treat metastases. Three patients had complete resolution of metastasis after chemotherapy. Disease-free/progression-free survival were compared with real world data where metastatic disease was treated with non-curative intent. The DFS/PFS for breast, gastric/oesophageal, and rectal cancer were 18.4 verses 6-13.3 months, 10.5 verses 5.6 months, and 15 verses 9.6 months respectively. Approaching oligometastasis with an intent of cure has shown to achieve reasonable local control/cure in our study and improve the DFS/PFS on comparison with real world data.