Practical management of oligometastatic gastric cancer

Gastric cancer is one of the types of cancer with a high prevalence of morbidity. The frequency of esophagogastric junction cancer, 5-year survival rates, perioperative adjuvant therapy, and standard chemotherapeutic regimens for gastric cancer vary between Asian countries and the West. Although oligometastasis is considered an intermediate state between localized and systemic disease, no standardized definition regarding metastatic organ sites or international consensus in gastric cancer exists. Both local treatment, such as radical surgery and radiotherapy, and systemic chemotherapy can be employed for treating patients with gastric cancer with oligometastatic disease. Recently, evidence for oligometastatic gastric cancer has been accumulated, including findings from several clinical trials conducted in Asian and Western countries, focusing on both organ-specific and non-organ-specific oligometastatic gastric cancer. Here, we review the latest findings on oligometastasis in gastric cancer, including variations in treatment strategies between Western and Asian countries. Further investigation is needed to determine the most favorable practical management strategies for patients with metachronous oligometastasis in gastric cancer, including the use of molecular-targeted agents and immune checkpoint inhibitors. The results of ongoing trials may shed light on the optimal treatment approaches for oligometastatic disease.