EORTC Lung Cancer Group survey on the definition of NSCLC synchronous oligometastatic disease

• Published in: European journal of cancer (1990) Vol. 122; pp. 109 - 114
• Main Authors: Levy, Antonin, Hendriks, Lizza E.L., Berghmans, Thierry, Faivre-Finn, Corinne, GiajLevra, Matteo, GiajLevra, Niccolò, Hasan, Baktiar, Pochesci, Alessia, Girard, Nicolas, Greillier, Laurent, Lantuéjoul, Sylvie, Edwards, John, O'Brien, Mary, Reck, Martin, Besse, Benjamin, Novello, Silvia, Dingemans, Anne-Marie C.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-11-2019; Elsevier Science Ltd; Elsevier
• Subjects: Adult; Aged; Cancer; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - pathology; Clinical trials; Computed tomography; Consensus; Female; Humans; Life Sciences; Lung cancer; Lymph nodes; Lymph Nodes - pathology; Lymphatic system; Magnetic resonance imaging; Male; Mediastinum - pathology; Medical research; Metastases; Metastasis; Middle Aged; Neoplasm Metastasis - diagnosis; Neoplasm Staging - methods; Neuroimaging; Non-small cell lung cancer; Non-small cell lung carcinoma; Oligometastasis; Oncology; Organs; Physicians; Polls & surveys; Positron emission; Positron emission tomography; Radiation; Small cell lung carcinoma; Thorax; Tomography; Oligometastasis; Consensus; Non-small cell lung cancer
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2019.09.012

Synchronous oligometastatic disease (sOM) has been described as a distinct disease entity; however, there is no consensus on OM definition (OM-d) in non–small-cell lung cancer (NSCLC). A consensus group was formed aiming to agree on a common OM-d that could be used in future clinical trials. A European survey was circulated to generate questions and input for the consensus group meeting.
A European Organisation for Research and Treatment of Cancer Lung Cancer Group (LCG)/sOM-d consensus group survey was distributed to LCG, sOM-d consensus group, and several European thoracic oncology societies’ members.
444 responses were analysed (radiation oncologist: 55% [n = 242], pulmonologist: 15% [n = 66], medical oncologist: 14% [n = 64]). 361 physicians (81%) aimed to cure sOM NSCLC patients and 82% (n = 362) included the possibility of radical intent treatment in their sOM-d. The maximum number of metastases considered in sOM-d varied: 12% replied 1 metastasis, 42% ≤ 3, and 17% ≥ 5 metastases. 79% (n = 353) stated that number of organs involved was important for sOM-d, and most (80%, n = 355) considered that only ≤3 involved organs (excluding primary) should be included. 317 (72%) included mediastinal lymph node involvement in the sOM-d and 22% (n = 70/317) counted mediastinal lymph node as a metastatic site. Most physicians completed sOM staging with brain magnetic resonance imaging (91%, n = 403) and positron emission tomography/computed tomography (98%, n = 437). Pathology proof of metastatic disease was a requirement to define sOM for 315 (71%) physicians. The preferred primary outcome for sOM clinical trials was overall survival (73%, n = 325).
Although consensual answers were obtained, several issues remain unresolved and will require further research to agree on a sOM-d.
•The majority aimed to cure sOM NSCLC patients.•The maximum number of metastases considered in sOM-d was 42% ≤ 3 and 17% ≥ 5.•Most considered only ≤3 involved organs (excluding primary).•Few counted mediastinal lymph node as a metastatic site.•The preferred primary outcome for sOM clinical trials was overall survival.