What is oligometastatic disease?

From the Guidelines

Oligometastatic disease refers to a clinical state characterized by a limited number of metastatic lesions, typically fewer than five, in patients with cancer 1. This condition is often identified through imaging modalities such as positron emission tomography (PET) or magnetic resonance imaging (MRI), and may be amenable to local therapies such as surgical resection or stereotactic body radiation therapy (SBRT) 1.

Key Characteristics of Oligometastatic Disease

• Limited number of metastatic lesions, typically fewer than five 1
• May be identified through imaging modalities such as PET or MRI 1
• May be amenable to local therapies such as surgical resection or SBRT 1
• Patients may also receive systemic therapies, including medications such as chemotherapy or targeted agents, with dosing regimens tailored to the individual's specific cancer type and disease burden 1

Treatment Approaches for Oligometastatic Disease

• Local therapies such as surgical resection or SBRT may be considered for patients with oligometastatic disease 1
• Systemic therapies such as chemotherapy or targeted agents may also be used, with dosing regimens tailored to the individual's specific cancer type and disease burden 1
• Treatment approaches may vary depending on the specific type of cancer, the location and number of metastatic lesions, and the individual patient's overall health and preferences 1

From the Research

Definition of Oligometastatic Disease

• Oligometastatic disease refers to a distinct state in patients with cancer characterized by a low metastatic burden, with diagnosis being informed by a limited number of distant metastases in radiologic imaging 2.
• It is defined as an intermediate state between localized cancer and widespread systemic metastases 3.
• Oligometastatic disease is generally defined as a stage of clinically or radiographically demonstrated metastatic disease limited in total disease burden and without rapid spread 4.

Characteristics of Oligometastatic Disease

• The diagnosis of oligometastatic disease is mainly based on the results of X-ray studies, as no driver and somatic mutations specific to oligometastatic disease are currently established 5.
• Oligometastatic disease can be classified into different types, including induced oligometastatic disease, genuine oligometastatic disease, recurrent oligometastatic disease, and de novo oligometastatic disease 5.
• De novo oligometastatic disease can be further divided into synchronous and metachronous forms, depending on the length of time from the primary diagnosis to the first evidence of oligometastatic disease 5.

Treatment and Management of Oligometastatic Disease

• Local ablative therapy, such as stereotactic body radiation therapy, can be curative for patients with oligometastatic disease 5.
• Interventional oncology treatments, including ablation, chemoembolization, radioembolization, and irreversible electroporation, can offer patients a decreasing overall tumor burden, minimizing cancer morbidity, and early evidence suggests a survival benefit 4.
• Combined systemic-ablative local treatment approaches are being developed for cancers of similar behavior, and biology-driven and imaging-oriented approaches are being investigated to better identify metastatic profiles for treatment guidance 6.