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
Processing time: 204 Days and 17.4 Hours
ARTICLE HIGHLIGHTS
Research background

Oesophageal cancer is the eighth most common cancer worldwide with an associated poor prognosis. The 5-year survival rate rarely exceeds 5% in case of metastatic disease. Combined treatment modalities are used for the management of locally advanced disease, consisting of neoadjuvant chemotherapy with or without radiotherapy followed by surgery. Meanwhile, patients with recurrent or metastatic disease most commonly undergo systemic palliative therapy. However, to date there is a lack in specific guidelines regarding optimal management of patients presenting with oligometastatic oesophageal cancer. The European Society for Medical Oncology, suggests that patients with metastasis can be considered for different options of treatment depending on the clinical case. It is unclear for current studies whether resection improves the overall survival and what is the optimal management.

Research motivation

This systematic review focuses on the current practice regarding treatment of oligometastatic oesophageal cancer and factors affecting survival following treatment of oligometastasis.

Research objectives

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

Research methods

An extensive systematic search of the literature was performed in Cochrance Library, MEDLINE and EMBASE databases on January 4th, 2019. Relevant electronic databases were searched for studies assessing the clinical outcome of oligometastasis.

Research results

The main finding of this systematic review is that 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. However, there is an increasing shift toward individualized, multidisciplinary management of oligometastasis because it is difficult to conduct randomized controlled trials due to the variety of presentations.

Research conclusions

The lung and liver are amongst the most common sites of metastasis in oesophageal cancer. Most studies advocate a personalised approach to patient management until there are more studies to guide future decision making. Aggressive treatment of oligometastatic disease in oesophageal cancer is performed on an individual basis. Several factors have been identified which might influence survival and should be taken into consideration in the management of oligometastasis. Most studies advocate a personalised approach in the management of oligometastatic oesophageal cancer.

Research perspectives

The current management advocated by most studies is based on a personalised approach to patient management until there are more studies to guide future decision making. Larger scale future studies or randomised controlled trials to assess optimal management plan for oligometastatic disease is required to guide management of this patient cohort.