Definition of Synchronous Oligometastatic Non–Small Cell Lung Cancer—A Consensus Report

Anne Marie C. Dingemans; Lizza E.L. Hendriks; Thierry Berghmans; Antonin Levy; Baktiar Hasan; Corinne Faivre-Finn; Matteo Giaj-Levra; Niccolò Giaj-Levra; Nicolas Girard; Laurent Greillier; Sylvie Lantuéjoul; John Edwards; Mary O'Brien; Martin Reck; Egbert F. Smit; Paul Van Schil; Pieter E. Postmus; Sara Ramella; Yolande Lievens; Mina Gaga; Nir Peled; Giorgio V. Scagliotti; Suresh Senan; Luiz Paz-Ares; Matthias Guckenberger; Fiona McDonald; Simon Ekman; Tanja Cufer; Hester Gietema; Maurizio Infante; Rafal Dziadziuszko; Solange Peters; Ramon Rami Porta; Johan Vansteenkiste; Christophe Dooms; Dirk de Ruysscher; Benjamin Besse; Silvia Novello

doi:10.1016/j.jtho.2019.07.025

Definition of Synchronous Oligometastatic Non–Small Cell Lung Cancer—A Consensus Report

Anne Marie C. Dingemans^*, Lizza E.L. Hendriks, Thierry Berghmans, Antonin Levy, Baktiar Hasan, Corinne Faivre-Finn, Matteo Giaj-Levra, Niccolò Giaj-Levra, Nicolas Girard, Laurent Greillier, Sylvie Lantuéjoul, John Edwards, Mary O'Brien, Martin Reck, Egbert F. Smit, Paul Van Schil, Pieter E. Postmus, Sara Ramella, Yolande Lievens, Mina GagaNir Peled, Giorgio V. Scagliotti, Suresh Senan, Luiz Paz-Ares, Matthias Guckenberger, Fiona McDonald, Simon Ekman, Tanja Cufer, Hester Gietema, Maurizio Infante, Rafal Dziadziuszko, Solange Peters, Ramon Rami Porta, Johan Vansteenkiste, Christophe Dooms, Dirk de Ruysscher, Benjamin Besse, Silvia Novello

^*Corresponding author for this work

Pulmonary Medicine

Research output: Contribution to journal › Article › Academic › peer-review

220 Citations (Scopus)

Abstract

Introduction:

Improved outcome has been shown in patients with synchronous oligometastatic (sOM) NSCLC when treated with radical intent. As a uniform definition of sOM NSCLC is lacking, we developed a definition and diagnostic criteria by a consensus process.

Methods:

A pan-European multidisciplinary consensus group was established. Consensus questions were built on the basis of current controversies, and definitions were extracted from a survey, cases and a systematic review. This statement was formulated during a consensus meeting.

Results:

It was determined that definition of sOM NSCLC is relevant when a radical treatment that may modify the disease course (leading to long-term disease control) is technically feasible for all tumor sites with acceptable toxicity. On the basis of the review, a maximum of five metastases and three organs was proposed. Mediastinal lymph node involvement was not counted as a metastatic site. Fludeoxyglucose F 18 positron emission tomography–computed tomography and brain imaging were considered mandatory. A dedicated liver magnetic resonance imaging scan was advised for a solitary liver metastasis, and thoracoscopy and biopsies of distant ipsilateral pleural sites were recommended for a solitary pleural metastasis. For mediastinal staging, fludeoxyglucose F 18 positron emission tomography–computed tomography was deemed the minimum requirement, with pathological confirmation recommended if this influences the treatment strategy. Biopsy of a solitary metastatic location was mandated unless the multidisciplinary team is of the opinion that the risks outweigh the benefits.

Conclusion:

A multidisciplinary consensus statement on the definition and staging of sOM NSCLC has been formulated. This statement will help to standardize inclusion criteria in future clinical trials.

Original language	English
Pages (from-to)	2109-2119
Number of pages	11
Journal	Journal of Thoracic Oncology
Volume	14
Issue number	12
DOIs	https://doi.org/10.1016/j.jtho.2019.07.025
Publication status	Published - Dec 2019

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EMC MM-04-42-02

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jtho.2019.07.025

http://hdl.handle.net/1765/122300

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Dingemans, A. M. C., Hendriks, L. E. L., Berghmans, T., Levy, A., Hasan, B., Faivre-Finn, C., Giaj-Levra, M., Giaj-Levra, N., Girard, N., Greillier, L., Lantuéjoul, S., Edwards, J., O'Brien, M., Reck, M., Smit, E. F., Van Schil, P., Postmus, P. E., Ramella, S., Lievens, Y., ... Novello, S. (2019). Definition of Synchronous Oligometastatic Non–Small Cell Lung Cancer—A Consensus Report. Journal of Thoracic Oncology, 14(12), 2109-2119. https://doi.org/10.1016/j.jtho.2019.07.025

@article{b9653bba50aa4a318b18676d9c99dfff,

title = "Definition of Synchronous Oligometastatic Non–Small Cell Lung Cancer—A Consensus Report",

abstract = "Introduction: Improved outcome has been shown in patients with synchronous oligometastatic (sOM) NSCLC when treated with radical intent. As a uniform definition of sOM NSCLC is lacking, we developed a definition and diagnostic criteria by a consensus process. Methods: A pan-European multidisciplinary consensus group was established. Consensus questions were built on the basis of current controversies, and definitions were extracted from a survey, cases and a systematic review. This statement was formulated during a consensus meeting.Results: It was determined that definition of sOM NSCLC is relevant when a radical treatment that may modify the disease course (leading to long-term disease control) is technically feasible for all tumor sites with acceptable toxicity. On the basis of the review, a maximum of five metastases and three organs was proposed. Mediastinal lymph node involvement was not counted as a metastatic site. Fludeoxyglucose F 18 positron emission tomography–computed tomography and brain imaging were considered mandatory. A dedicated liver magnetic resonance imaging scan was advised for a solitary liver metastasis, and thoracoscopy and biopsies of distant ipsilateral pleural sites were recommended for a solitary pleural metastasis. For mediastinal staging, fludeoxyglucose F 18 positron emission tomography–computed tomography was deemed the minimum requirement, with pathological confirmation recommended if this influences the treatment strategy. Biopsy of a solitary metastatic location was mandated unless the multidisciplinary team is of the opinion that the risks outweigh the benefits. Conclusion: A multidisciplinary consensus statement on the definition and staging of sOM NSCLC has been formulated. This statement will help to standardize inclusion criteria in future clinical trials.",

author = "Dingemans, {Anne Marie C.} and Hendriks, {Lizza E.L.} and Thierry Berghmans and Antonin Levy and Baktiar Hasan and Corinne Faivre-Finn and Matteo Giaj-Levra and Niccol{\`o} Giaj-Levra and Nicolas Girard and Laurent Greillier and Sylvie Lantu{\'e}joul and John Edwards and Mary O'Brien and Martin Reck and Smit, {Egbert F.} and {Van Schil}, Paul and Postmus, {Pieter E.} and Sara Ramella and Yolande Lievens and Mina Gaga and Nir Peled and Scagliotti, {Giorgio V.} and Suresh Senan and Luiz Paz-Ares and Matthias Guckenberger and Fiona McDonald and Simon Ekman and Tanja Cufer and Hester Gietema and Maurizio Infante and Rafal Dziadziuszko and Solange Peters and Porta, {Ramon Rami} and Johan Vansteenkiste and Christophe Dooms and {de Ruysscher}, Dirk and Benjamin Besse and Silvia Novello",

year = "2019",

month = dec,

doi = "10.1016/j.jtho.2019.07.025",

language = "English",

volume = "14",

pages = "2109--2119",

journal = "Journal of Thoracic Oncology",

issn = "1556-0864",

publisher = "Elsevier Inc.",

number = "12",

}

Dingemans, AMC, Hendriks, LEL, Berghmans, T, Levy, A, Hasan, B, Faivre-Finn, C, Giaj-Levra, M, Giaj-Levra, N, Girard, N, Greillier, L, Lantuéjoul, S, Edwards, J, O'Brien, M, Reck, M, Smit, EF, Van Schil, P, Postmus, PE, Ramella, S, Lievens, Y, Gaga, M, Peled, N, Scagliotti, GV, Senan, S, Paz-Ares, L, Guckenberger, M, McDonald, F, Ekman, S, Cufer, T, Gietema, H, Infante, M, Dziadziuszko, R, Peters, S, Porta, RR, Vansteenkiste, J, Dooms, C, de Ruysscher, D, Besse, B & Novello, S 2019, 'Definition of Synchronous Oligometastatic Non–Small Cell Lung Cancer—A Consensus Report', Journal of Thoracic Oncology, vol. 14, no. 12, pp. 2109-2119. https://doi.org/10.1016/j.jtho.2019.07.025

TY - JOUR

T1 - Definition of Synchronous Oligometastatic Non–Small Cell Lung Cancer—A Consensus Report

AU - Dingemans, Anne Marie C.

AU - Hendriks, Lizza E.L.

AU - Berghmans, Thierry

AU - Levy, Antonin

AU - Hasan, Baktiar

AU - Faivre-Finn, Corinne

AU - Giaj-Levra, Matteo

AU - Giaj-Levra, Niccolò

AU - Girard, Nicolas

AU - Greillier, Laurent

AU - Lantuéjoul, Sylvie

AU - Edwards, John

AU - O'Brien, Mary

AU - Reck, Martin

AU - Smit, Egbert F.

AU - Van Schil, Paul

AU - Postmus, Pieter E.

AU - Ramella, Sara

AU - Lievens, Yolande

AU - Gaga, Mina

AU - Peled, Nir

AU - Scagliotti, Giorgio V.

AU - Senan, Suresh

AU - Paz-Ares, Luiz

AU - Guckenberger, Matthias

AU - McDonald, Fiona

AU - Ekman, Simon

AU - Cufer, Tanja

AU - Gietema, Hester

AU - Infante, Maurizio

AU - Dziadziuszko, Rafal

AU - Peters, Solange

AU - Porta, Ramon Rami

AU - Vansteenkiste, Johan

AU - Dooms, Christophe

AU - de Ruysscher, Dirk

AU - Besse, Benjamin

AU - Novello, Silvia

PY - 2019/12

Y1 - 2019/12

N2 - Introduction: Improved outcome has been shown in patients with synchronous oligometastatic (sOM) NSCLC when treated with radical intent. As a uniform definition of sOM NSCLC is lacking, we developed a definition and diagnostic criteria by a consensus process. Methods: A pan-European multidisciplinary consensus group was established. Consensus questions were built on the basis of current controversies, and definitions were extracted from a survey, cases and a systematic review. This statement was formulated during a consensus meeting.Results: It was determined that definition of sOM NSCLC is relevant when a radical treatment that may modify the disease course (leading to long-term disease control) is technically feasible for all tumor sites with acceptable toxicity. On the basis of the review, a maximum of five metastases and three organs was proposed. Mediastinal lymph node involvement was not counted as a metastatic site. Fludeoxyglucose F 18 positron emission tomography–computed tomography and brain imaging were considered mandatory. A dedicated liver magnetic resonance imaging scan was advised for a solitary liver metastasis, and thoracoscopy and biopsies of distant ipsilateral pleural sites were recommended for a solitary pleural metastasis. For mediastinal staging, fludeoxyglucose F 18 positron emission tomography–computed tomography was deemed the minimum requirement, with pathological confirmation recommended if this influences the treatment strategy. Biopsy of a solitary metastatic location was mandated unless the multidisciplinary team is of the opinion that the risks outweigh the benefits. Conclusion: A multidisciplinary consensus statement on the definition and staging of sOM NSCLC has been formulated. This statement will help to standardize inclusion criteria in future clinical trials.

AB - Introduction: Improved outcome has been shown in patients with synchronous oligometastatic (sOM) NSCLC when treated with radical intent. As a uniform definition of sOM NSCLC is lacking, we developed a definition and diagnostic criteria by a consensus process. Methods: A pan-European multidisciplinary consensus group was established. Consensus questions were built on the basis of current controversies, and definitions were extracted from a survey, cases and a systematic review. This statement was formulated during a consensus meeting.Results: It was determined that definition of sOM NSCLC is relevant when a radical treatment that may modify the disease course (leading to long-term disease control) is technically feasible for all tumor sites with acceptable toxicity. On the basis of the review, a maximum of five metastases and three organs was proposed. Mediastinal lymph node involvement was not counted as a metastatic site. Fludeoxyglucose F 18 positron emission tomography–computed tomography and brain imaging were considered mandatory. A dedicated liver magnetic resonance imaging scan was advised for a solitary liver metastasis, and thoracoscopy and biopsies of distant ipsilateral pleural sites were recommended for a solitary pleural metastasis. For mediastinal staging, fludeoxyglucose F 18 positron emission tomography–computed tomography was deemed the minimum requirement, with pathological confirmation recommended if this influences the treatment strategy. Biopsy of a solitary metastatic location was mandated unless the multidisciplinary team is of the opinion that the risks outweigh the benefits. Conclusion: A multidisciplinary consensus statement on the definition and staging of sOM NSCLC has been formulated. This statement will help to standardize inclusion criteria in future clinical trials.

UR - http://www.scopus.com/inward/record.url?scp=85074170416&partnerID=8YFLogxK

U2 - 10.1016/j.jtho.2019.07.025

DO - 10.1016/j.jtho.2019.07.025

M3 - Article

C2 - 31398540

SN - 1556-0864

VL - 14

SP - 2109

EP - 2119

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

IS - 12

ER -

Definition of Synchronous Oligometastatic Non–Small Cell Lung Cancer—A Consensus Report

Abstract

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