Recognition of and treatment recommendations for oligometastatic disease in multidisciplinary tumor boards
Background and introduction: Growing evidence supports a combined modality treatment strategy for patients with oligometastatic disease. However, lack of phase III trial data and uncertainties around patient selection highlight the importance of multidisciplinary tumor boards (MDT) in therapeutic de...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630822001070 |
| _version_ | 1811201693160833024 |
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| author | Sebastian M. Christ Philip Heesen Urs J. Muehlematter Kaspar Pohl Gabriel William Thiel Jonas Willmann Maiwand Ahmadsei Tiuri E. Kroese Michael Mayinger Panagiotis Balermpas Andreas Wicki Nicolaus Andratschke Martin Huellner Matthias Guckenberger |
| author_facet | Sebastian M. Christ Philip Heesen Urs J. Muehlematter Kaspar Pohl Gabriel William Thiel Jonas Willmann Maiwand Ahmadsei Tiuri E. Kroese Michael Mayinger Panagiotis Balermpas Andreas Wicki Nicolaus Andratschke Martin Huellner Matthias Guckenberger |
| author_sort | Sebastian M. Christ |
| collection | DOAJ |
| description | Background and introduction: Growing evidence supports a combined modality treatment strategy for patients with oligometastatic disease. However, lack of phase III trial data and uncertainties around patient selection highlight the importance of multidisciplinary tumor boards (MDT) in therapeutic decision-making. This study aimed to analyze the recognition of and treatment recommendations for oligometastatic patients by MDTs at a large comprehensive cancer center in order to better understand current treatment patterns of oligometastasis. Materials and methods: For this retrospective single-center cross-sectional study, oligometastatic patients were identified by screening oncological PET and concurrent brain MRI scans conducted at our center in 2020. MDT discussions and recommendations within four weeks of the imaging diagnosis of oligometastasis were analyzed. Logistic regression analysis was used to identify predictors for the addition of local therapy to standard-of-care. Results: A total of 787 oligometastatic cases were identified. Lung cancer and mesothelioma, skin cancer, and prostate cancer were the most common histologies with 231 (29 %), 160 (20 %), and 84 (11 %) cases, respectively. Almost half of the cases (46 %) had one distant metastasis on imaging only. More than half (56 %) of all oligometastatic cases were discussed at an MDT. In 47 % of cases, for which a therapeutic recommendation was reached in an MDT, local therapy was part of the therapeutic strategy. On logistic regression analysis, oligometastatic skin cancer was significantly associated with a recommendation for local therapy (p < 0.05), whereas the number of oligometastases was not (p = 0.202). Conclusion: More than half of oligometastatic cases were discussed in MDTs, of which more than every second received a recommendation including the addition of local therapy. This frequency of MDT use underscores the importance of multidisciplinary decision-making, yet efforts should be increased to standardize reporting and use standard nomenclature on oligometastasis in MDTs to better frame multidisciplinary discussion. |
| first_indexed | 2024-04-12T02:25:58Z |
| format | Article |
| id | doaj.art-a35abaf8c7ec441099bba457f8eba5d4 |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-04-12T02:25:58Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-a35abaf8c7ec441099bba457f8eba5d42022-12-22T03:52:00ZengElsevierClinical and Translational Radiation Oncology2405-63082023-01-0138123129Recognition of and treatment recommendations for oligometastatic disease in multidisciplinary tumor boardsSebastian M. Christ0Philip Heesen1Urs J. Muehlematter2Kaspar Pohl3Gabriel William Thiel4Jonas Willmann5Maiwand Ahmadsei6Tiuri E. Kroese7Michael Mayinger8Panagiotis Balermpas9Andreas Wicki10Nicolaus Andratschke11Martin Huellner12Matthias Guckenberger13Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Corresponding author at: Department of Radiation Oncology, University Hospital Zurich, University Zurich, Rämistrasse 100, Zurich 8091, Switzerland.Faculty of Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandFaculty of Medicine, University of Zurich, Zurich, SwitzerlandFaculty of Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Medical Oncology and Hematology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandBackground and introduction: Growing evidence supports a combined modality treatment strategy for patients with oligometastatic disease. However, lack of phase III trial data and uncertainties around patient selection highlight the importance of multidisciplinary tumor boards (MDT) in therapeutic decision-making. This study aimed to analyze the recognition of and treatment recommendations for oligometastatic patients by MDTs at a large comprehensive cancer center in order to better understand current treatment patterns of oligometastasis. Materials and methods: For this retrospective single-center cross-sectional study, oligometastatic patients were identified by screening oncological PET and concurrent brain MRI scans conducted at our center in 2020. MDT discussions and recommendations within four weeks of the imaging diagnosis of oligometastasis were analyzed. Logistic regression analysis was used to identify predictors for the addition of local therapy to standard-of-care. Results: A total of 787 oligometastatic cases were identified. Lung cancer and mesothelioma, skin cancer, and prostate cancer were the most common histologies with 231 (29 %), 160 (20 %), and 84 (11 %) cases, respectively. Almost half of the cases (46 %) had one distant metastasis on imaging only. More than half (56 %) of all oligometastatic cases were discussed at an MDT. In 47 % of cases, for which a therapeutic recommendation was reached in an MDT, local therapy was part of the therapeutic strategy. On logistic regression analysis, oligometastatic skin cancer was significantly associated with a recommendation for local therapy (p < 0.05), whereas the number of oligometastases was not (p = 0.202). Conclusion: More than half of oligometastatic cases were discussed in MDTs, of which more than every second received a recommendation including the addition of local therapy. This frequency of MDT use underscores the importance of multidisciplinary decision-making, yet efforts should be increased to standardize reporting and use standard nomenclature on oligometastasis in MDTs to better frame multidisciplinary discussion.http://www.sciencedirect.com/science/article/pii/S2405630822001070OligometastasisMultidisciplinary tumor boardLocal therapy |
| spellingShingle | Sebastian M. Christ Philip Heesen Urs J. Muehlematter Kaspar Pohl Gabriel William Thiel Jonas Willmann Maiwand Ahmadsei Tiuri E. Kroese Michael Mayinger Panagiotis Balermpas Andreas Wicki Nicolaus Andratschke Martin Huellner Matthias Guckenberger Recognition of and treatment recommendations for oligometastatic disease in multidisciplinary tumor boards Clinical and Translational Radiation Oncology Oligometastasis Multidisciplinary tumor board Local therapy |
| title | Recognition of and treatment recommendations for oligometastatic disease in multidisciplinary tumor boards |
| title_full | Recognition of and treatment recommendations for oligometastatic disease in multidisciplinary tumor boards |
| title_fullStr | Recognition of and treatment recommendations for oligometastatic disease in multidisciplinary tumor boards |
| title_full_unstemmed | Recognition of and treatment recommendations for oligometastatic disease in multidisciplinary tumor boards |
| title_short | Recognition of and treatment recommendations for oligometastatic disease in multidisciplinary tumor boards |
| title_sort | recognition of and treatment recommendations for oligometastatic disease in multidisciplinary tumor boards |
| topic | Oligometastasis Multidisciplinary tumor board Local therapy |
| url | http://www.sciencedirect.com/science/article/pii/S2405630822001070 |
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