Oligometastatic Gastric Cancer: Novel Considerations for Personalized Approach

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Metastatic gastric cancer (stage M1) traditionally excludes surgical options, directing patients to palliative care.
• Oligometastatic disease represents an intermediate stage between localized and widely metastatic gastric cancer.
• Current management lacks evidence-based guidelines for this specific clinical entity.

Purpose of the Study:

• To review the current literature on the multimodal treatment of oligometastatic gastric disease.
• To explore the potential role of surgical intervention in selected cases of oligometastatic gastric cancer.
• To highlight the need for tailored strategies in managing this condition.

Main Methods:

• Literature search on current multimodal treatment strategies for oligometastatic gastric disease.
• Discussion of "conversion therapy" as a surgical approach for initially unresectable or borderline resectable tumors.
• Emphasis on the importance of neoadjuvant treatment prior to surgical intervention.

Main Results:

• Locoregional treatments, including surgery, may offer long-term survival or cure in highly selected oligometastatic gastric cancer patients.
• Surgical goals include locoregional control, complete tumor resection (R0), lymph node dissection, and uncomplicated anastomosis.
• Disease progression necessitates a shift to palliative treatment.

Conclusions:

• The decision for surgical intervention in oligometastatic gastric cancer requires strict criteria and multidisciplinary evaluation.
• Experienced surgeons and oncologists are essential for selecting appropriate candidates for operative management.
• Multimodal treatment strategies are key for optimizing outcomes in this challenging patient group.