Better survival of patients with oligo- compared with polymetastatic cancers:  a systematic review and meta-analysis of 173 studies

Abstract

Background: The modern concept of oligometastatic (OM) state has been initially developed to describe patients with a low burden of disease and with a potential for cure with local ablative treatments. We systematically assessed the risk of death and relapse of oligometastatic (OM) cancers compared to cancers with more diffuse metastatic spread, through a meta-analysis of published data. Methods: PubMed, the Cochrane Library, and EMBASE were searched for studies reporting prognosis of patients with OM solid tumors. Risk of death and relapse were extracted and pooled to provide an adjusted hazard ratio with a 95% confidence interval (HR 95%CI). The primary outcome of the study refers to overall mortality in OM vs. polymetastatic (PM) patients. Results. Mortality and relapse associated with OM state in patients with cancer were evaluated among 104,234 participants (n=173 studies). Progression-free survival was better in patients with OM disease (hazard ratio [HR] = 0.62, 95% CI 0.57–0.68; P <.001; n=69 studies). Also, OM cancers were associated with a better OS (HR = 0.65, 95% CI 0.62-0.68; P<.01; n=161 studies). In colorectal (CRC), breast, non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC) the reduction in the risk of death for OM patients were 35, 38, 30 and 42%, respectively. Conclusions. Patients with oligometastases have a significantly better prognosis than those with more widespread stage IV tumors. We suggest that a treatment strategy that involves bot the primary and the metastases should be identified at the time of diagnosis.

Better survival of patients with oligo- compared with polymetastatic cancers: a systematic review and meta-analysis of 173 studies

“…http://dx.doi.org/10.17632/8kycvdnp6v.1. 10 Data are available under the terms of the Creative Commons Attribution 4.0 license (CC-BY 4.0).…”

Defining oligometastatic state in uro-oncological cancers

“…Moreover, oligometastatic cancers exhibit an intermediate state between localized and systematic metastasized disease, reflecting an early stage in the chain of progression, where the tumors have a constrained capacity for widespread metastasis [1]. In a metaanalysis of 173 studies by Petrelli et al, patients with oligometastatic disease had superior prognosis than those with widespread polymetastatic tumors [2]. Therefore beside their distinct biological behavior, these tumors represent a unique clinical entity, with a potential for long-term disease control or even cure [1,2].…”

“…In a meta-analysis of 173 studies by Petrelli et al , patients with oligometastatic disease had superior prognosis than those with widespread polymetastatic tumors [2]. Therefore beside their distinct biological behavior, these tumors represent a unique clinical entity, with a potential for long-term disease control or even cure [1,2]. The classification system of oligometastatic tumors was formed through a Delphi consensus led by Guckenberger et al in 2020, reflecting their different biological features [3 ▪▪ ].…”

Contralateral axillary lymph node metastasis in breast cancer: An oligometastatic-like disease

“…In recent years, oligometastasis (OM), a unique intermediate state between locally confined disease and systemic metastatic disease [ 30 ], has attracted increasing attention. It was first proposed by Hellman and Weichselbaum in 1995 to describe a subset of states with a limited number and sites of metastases [ 31 ], emphasizing relatively restricted tumor burden and better outcomes than that of polymetastasis [ 32 , 33 ]. Dorn et al [ 34 ] showed that in breast cancer, patients with oligometastasis had a higher 5-year (59.6 % vs. 11.6 %) and median survival (107 vs. 22 months, p = 0.001) compared to those with polymetastases.…”