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.
- Dingemans, A. C.
- Hendriks, L. E. L.
- Berghmans, T.
- Levy, A.
- Hasan, B.
- Faivre-Finn, C.
- Giaj-Levra, M.
- Giaj-Levra, N.
- Girard, N.
- Greillier, L.
- Lantuejoul, S.
- Edwards, J.
- O'Brien, M.
- Reck, M.
- Smit, E. F.
- Van Schil, P.
- Postmus, P. E.
- Ramella, S.
- Lievens, Y.
- Gaga, M.
- Peled, N.
- Scagliotti, G. V.
- Senan, S.
- Paz-Ares, L.
- Guckenberger, M.
- McDonald, F.
- Ekman, S.
- Cufer, T.
- Gietema, H.
- Infante, M.
- Dziadziuszko, R.
- Peters, S.
- Porta, R. R.
- Vansteenkiste, J.
- Dooms, C.
- de Ruysscher, D.
- Besse, B.
- Novello, S.
Keywords
- Consensus definition
- Non-small cell lung cancer
- Oligometastatic disease
- Staging
