New Insights into Oligo-Recurrence of Various Cancers

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 8418

Special Issue Editors


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Guest Editor
Department of Public Health, Kurume University School of Medicine, Kurume, Japan
Interests: lung cancer; SBRT; breast cancer; uterine cervical cancer; radiation oncology; radiotherapy; oligometastases; oligo-recurrence

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Guest Editor
Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
Interests: breast surgical oncology; tumor biology; clinical trial and translational research
Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
Interests: thoracic surgery; surgical oncology

Special Issue Information

Dear Colleagues,

The most dramatic development in oncology areas in recent decades has been the demonstration of the value of adding local therapy to systemic therapy for oligo-recurrence (rarely, local therapy alone).

According to Niibe et al. (2006), oligo-recurrence is defined as having a controlled primary tumor with no more than five regional lymph nodes and/or distant metastasis/recurrence sites (including brain, viscera, bone, etc.). Furthermore, local treatment is performed on all active lesions.

While maintaining this general framework, the indications are subdivided individually for NSCLC, breast cancer, prostate cancer, etc. along with the oligo-recurrence treatment method.

This is becoming a specific treatment guideline and is very important. Underpinning this foundation are less invasive local therapies, rapidly increasing precision in diagnostic imaging, and cancer-specific advances in systemic therapy.

The theme of this Cancers Special Issue is “New Insights into Oligo-Recurrence of Various Cancers”. We are soliciting original papers and review papers for more precise definitions, treatment methods, diagnostic methods, etc. of oligo-recurrence that are more subdivided for each carcinoma. Through this Special Issue, we hope that oligo-recurrence will be widely applied, and great strides toward the next era will be achieved.

Prof. Dr. Yuzuru Niibe
Dr. Tadahiko Shien
Dr. Dai Sonoda
Guest Editors

Manuscript Submission Information

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Keywords

  • oligo-recurrence
  • diagnostic imaging
  • systemic therapy
  • local therapy
  • controlled primary tumor
  • regional lymph nodes
  • distant metastasis

Published Papers (6 papers)

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Research

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12 pages, 2181 KiB  
Article
Optimal Treatment Strategy for Oligo-Recurrence Lung Cancer Patients with Driver Mutations
by Taimei Tachibana, Yosuke Matsuura, Hironori Ninomiya, Junji Ichinose, Masayuki Nakao, Sakae Okumura, Makoto Nishio, Norihiko Ikeda and Mingyon Mun
Cancers 2024, 16(2), 464; https://doi.org/10.3390/cancers16020464 - 22 Jan 2024
Viewed by 834
Abstract
Background: The efficacy of local therapies for lung cancer patients with postoperative oligo-recurrence has been reported. However, whether local therapies should be chosen over molecular targeted therapies for oligo-recurrence patients with driver mutations remains controversial. Therefore, we aimed to investigate the optimal initial [...] Read more.
Background: The efficacy of local therapies for lung cancer patients with postoperative oligo-recurrence has been reported. However, whether local therapies should be chosen over molecular targeted therapies for oligo-recurrence patients with driver mutations remains controversial. Therefore, we aimed to investigate the optimal initial treatment strategy for oligo-recurrence in lung cancer patients with driver mutations. Methods: Among 2152 patients with lung adenocarcinoma who underwent surgical resection at our institute between 2008 and 2020, 66 patients with driver mutations who experienced cancer oligo-recurrence after surgery and were treated with local or molecularly targeted therapy as an initial therapy after recurrence were evaluated. Oligo-recurrence was characterized by the presence of 1 to 3 recurrent lesions. These patients were investigated, focusing on their post-recurrence therapies and prognoses. Results: The median follow-up period was 71 months. Local and molecular targeted therapies were administered to 41 and 25 patients, respectively. The number of recurrence lesions tended to be lower in the initial local therapy group than in the molecular targeted therapy group. In the initial local therapy group, 23 patients (56%) subsequently received molecular targeted therapies. The time from recurrence to the initiation of molecular targeted therapy was significantly longer in the local therapy group than in the molecular targeted therapy group (p < 0.001). There was no significant difference in post-recurrence overall survival (hazard ratio, 1.429; 95% confidence interval, 0.701–2.912; log-rank, p = 0.324) and post-recurrence progression-free survival (hazard ratio, 0.799; 95% confidence interval, 0.459–1.390; log-rank, p = 0.426) in the initial local ablative therapy group compared with the initial molecular targeted therapy group. Conclusions: Local therapies as a first-line treatment did not show statistically significant differences in post-recurrence survival or progression-free survival compared with molecular targeted therapies. However, local therapies as an initial treatment should be considered preferably, as they can cure the recurrence and can delay the start of administration of molecular targeted therapies. Full article
(This article belongs to the Special Issue New Insights into Oligo-Recurrence of Various Cancers)
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Review

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13 pages, 717 KiB  
Review
Oligometastases of Esophageal Squamous Cell Carcinoma: A Review
by Yuta Sato, Yoshihiro Tanaka, Ryoma Yokoi, Hiroshi Tsuchiya, Yuki Sengoku, Masahiro Fukada, Itaru Yasufuku, Ryuichi Asai, Jesse Yu Tajima, Shigeru Kiyama, Takazumi Kato, Katsutoshi Murase and Nobuhisa Matsuhashi
Cancers 2024, 16(4), 704; https://doi.org/10.3390/cancers16040704 - 07 Feb 2024
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Abstract
Patients with oligometastases show distant relapse in only a limited number of regions. Local therapy such as surgical resection, radiotherapy, chemoradiotherapy, and radiofrequency ablation for the relapsed sites may thus improve patient survival. Oligometastases are divided into oligo-recurrence and sync-oligometastases. Oligo-recurrence indicates a [...] Read more.
Patients with oligometastases show distant relapse in only a limited number of regions. Local therapy such as surgical resection, radiotherapy, chemoradiotherapy, and radiofrequency ablation for the relapsed sites may thus improve patient survival. Oligometastases are divided into oligo-recurrence and sync-oligometastases. Oligo-recurrence indicates a primary lesion that is controlled, and sync-oligometastases indicate a primary lesion that is not controlled. The management of oligo-recurrence and sync-oligometastases in esophageal squamous cell carcinoma has not been clearly established, and treatment outcomes remain equivocal. We reviewed 14 articles, including three phase II trials, that were limited to squamous cell carcinoma. Multimodal treatment combining surgical resection and chemoradiotherapy for oligo-recurrence of esophageal squamous cell carcinoma appears to be a promising treatment. With the development of more effective chemotherapy and regimens that combine immune checkpoint inhibitors, it will become more likely that sync-oligometastases that were unresectable at the initial diagnosis can be brought to conversion surgery. Currently, a randomized, controlled phase III trial is being conducted in Japan to compare a strategy for performing definitive chemoradiotherapy and, if necessary, salvage surgery with a strategy for conversion surgery in patients who can be resected by induction chemotherapy. Full article
(This article belongs to the Special Issue New Insights into Oligo-Recurrence of Various Cancers)
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12 pages, 248 KiB  
Review
Oligometastasis of Gastric Cancer: A Review
by Itaru Yasufuku, Hiroshi Tsuchiya, Seito Fujibayashi, Naoki Okumura, Yuki Sengoku, Masahiro Fukada, Ryuichi Asai, Yuta Sato, Jesse Yu Tajima, Shigeru Kiyama, Takazumi Kato, Yoshihiro Tanaka, Katsutoshi Murase and Nobuhisa Matsuhashi
Cancers 2024, 16(3), 673; https://doi.org/10.3390/cancers16030673 - 05 Feb 2024
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Abstract
The concept of oligometastasis is not yet fully established in the field of gastric cancer. However, metastatic lesions that are localized, technically resectable at diagnosis, present a certain response to preoperative chemotherapy, and present favorable survival outcomes with local treatments, sometimes in combination [...] Read more.
The concept of oligometastasis is not yet fully established in the field of gastric cancer. However, metastatic lesions that are localized, technically resectable at diagnosis, present a certain response to preoperative chemotherapy, and present favorable survival outcomes with local treatments, sometimes in combination with chemotherapy, are recognized as oligometastasis in the field of gastric cancer. Oligometastasis is noted in European Society for Medical Oncology guidelines and Japanese gastric cancer treatment guidelines, and local treatment is mentioned as one of the pivotal treatment options for oligometastasis. Solitary liver metastasis or a small number of liver metastases; retroperitoneal lymph node metastasis, especially localized para-aortic lymph node metastasis; localized peritoneal dissemination; and Krukenberg tumor are representative types of oligometastasis in gastric cancer. The AIO-FLOT3 trial prospectively evaluated the efficacy of multimodal treatments for gastric cancer with oligometastasis, including surgical resection of primary and metastatic lesions combined with chemotherapy, confirming favorable survival outcomes. Two phase 3 studies are ongoing to investigate the efficacy of surgical resection combined with perioperative chemotherapy compared with palliative chemotherapy. Thus far, the evidence suggests that multimodal treatment for oligometastasis of gastric cancer is promising. Full article
(This article belongs to the Special Issue New Insights into Oligo-Recurrence of Various Cancers)
13 pages, 476 KiB  
Review
Progress in Oligometastatic Prostate Cancer: Emerging Imaging Innovations and Therapeutic Approaches
by Ryo Oka, Takanobu Utsumi, Takahide Noro, Yuta Suzuki, Shota Iijima, Yuka Sugizaki, Takatoshi Somoto, Seiji Kato, Takumi Endo, Naoto Kamiya and Hiroyoshi Suzuki
Cancers 2024, 16(3), 507; https://doi.org/10.3390/cancers16030507 - 24 Jan 2024
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Abstract
Prostate cancer (PCa) exhibits a spectrum of heterogeneity, from indolent to highly aggressive forms, with approximately 10–20% of patients experiencing metastatic PCa. Oligometastatic PCa, characterized by a limited number of metastatic lesions in specific anatomical locations, has gained attention due to advanced imaging [...] Read more.
Prostate cancer (PCa) exhibits a spectrum of heterogeneity, from indolent to highly aggressive forms, with approximately 10–20% of patients experiencing metastatic PCa. Oligometastatic PCa, characterized by a limited number of metastatic lesions in specific anatomical locations, has gained attention due to advanced imaging modalities. Although patients with metastatic PCa typically receive systemic therapy, personalized treatment approaches for oligometastatic PCa are emerging, including surgical and radiotherapeutic interventions. This comprehensive review explores the latest developments in the field of oligometastatic PCa, including its biological mechanisms, advanced imaging techniques, and relevant clinical studies. Oligometastatic PCa is distinct from widespread metastases and presents challenges in patient classification. Imaging plays a crucial role in identifying and characterizing oligometastatic lesions, with new techniques such as prostate-specific membrane antigen positron emission tomography demonstrating a remarkable efficacy. The management strategies encompass cytoreductive surgery, radiotherapy targeting the primary tumor, and metastasis-directed therapy for recurrent lesions. Ongoing clinical trials are evaluating the effectiveness of these approaches. Oligometastatic PCa occupies a unique position between locally advanced and high-volume metastatic diseases. While a universally accepted definition and standardized diagnostic criteria are still evolving, emerging imaging technologies and therapeutic strategies hold promise for improving the patient outcomes in this intermediate stage of PCa. Full article
(This article belongs to the Special Issue New Insights into Oligo-Recurrence of Various Cancers)
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28 pages, 5285 KiB  
Review
Optimizing Treatment Strategy for Oligometastases/Oligo-Recurrence of Colorectal Cancer
by Ryoma Yokoi, Jesse Yu Tajima, Masahiro Fukada, Hirokatsu Hayashi, Masashi Kuno, Ryuichi Asai, Yuta Sato, Itaru Yasufuku, Shigeru Kiyama, Yoshihiro Tanaka, Katsutoshi Murase and Nobuhisa Matsuhashi
Cancers 2024, 16(1), 142; https://doi.org/10.3390/cancers16010142 - 27 Dec 2023
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Abstract
Colorectal cancer (CRC) is the third most common cancer, and nearly half of CRC patients experience metastases. Oligometastatic CRC represents a distinct clinical state characterized by limited metastatic involvement, demonstrating a less aggressive nature and potentially improved survival with multidisciplinary treatment. However, the [...] Read more.
Colorectal cancer (CRC) is the third most common cancer, and nearly half of CRC patients experience metastases. Oligometastatic CRC represents a distinct clinical state characterized by limited metastatic involvement, demonstrating a less aggressive nature and potentially improved survival with multidisciplinary treatment. However, the varied clinical scenarios giving rise to oligometastases necessitate a precise definition, considering primary tumor status and oncological factors, to optimize treatment strategies. This review delineates the concepts of oligometastatic CRC, encompassing oligo-recurrence, where the primary tumor is under control, resulting in a more favorable prognosis. A comprehensive examination of multidisciplinary treatment with local treatments and systemic therapy is provided. The overarching objective in managing oligometastatic CRC is the complete eradication of metastases, offering prospects of a cure. Essential to this management approach are local treatments, with surgical resection serving as the standard of care. Percutaneous ablation and stereotactic body radiotherapy present less invasive alternatives for lesions unsuitable for surgery, demonstrating efficacy in select cases. Perioperative systemic therapy, aiming to control micrometastatic disease and enhance local treatment effectiveness, has shown improvements in progression-free survival through clinical trials. However, the extension of overall survival remains variable. The review emphasizes the need for further prospective trials to establish a cohesive definition and an optimized treatment strategy for oligometastatic CRC. Full article
(This article belongs to the Special Issue New Insights into Oligo-Recurrence of Various Cancers)
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13 pages, 958 KiB  
Review
The Diagnosis and Treatment Approach for Oligo-Recurrent and Oligo-Progressive Renal Cell Carcinoma
by Kensuke Bekku, Tatsushi Kawada, Takanori Sekito, Kasumi Yoshinaga, Yuki Maruyama, Tomoaki Yamanoi, Yusuke Tominaga, Takuya Sadahira, Satoshi Katayama, Takehiro Iwata, Shingo Nishimura, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Motoo Araki and Yuzuru Niibe
Cancers 2023, 15(24), 5873; https://doi.org/10.3390/cancers15245873 - 17 Dec 2023
Viewed by 1006
Abstract
One-third of renal cell carcinomas (RCCs) without metastases develop metastatic disease after extirpative surgery for the primary tumors. The majority of metastatic RCC cases, along with treated primary lesions, involve limited lesions termed “oligo-recurrent” disease. The role of metastasis-directed therapy (MDT), including stereotactic [...] Read more.
One-third of renal cell carcinomas (RCCs) without metastases develop metastatic disease after extirpative surgery for the primary tumors. The majority of metastatic RCC cases, along with treated primary lesions, involve limited lesions termed “oligo-recurrent” disease. The role of metastasis-directed therapy (MDT), including stereotactic body radiation therapy (SBRT) and metastasectomy, in the treatment of oligo-recurrent RCC has evolved. Although the surgical resection of all lesions alone can have a curative intent, SBRT is a valuable treatment option, especially for patients concurrently receiving systemic therapy. Contemporary immune checkpoint inhibitor (ICI) combination therapies remain central to the management of metastatic RCC. However, one objective of MDT is to delay the initiation of systemic therapies, thereby sparing patients from potentially unnecessary burdens. Undertaking MDT for cases showing progression under systemic therapies, known as “oligo-progression”, can be complex in considering the treatment approach. Its efficacy may be diminished compared to patients with stable disease. SBRT combined with ICI can be a promising treatment for these cases because radiation therapy has been shown to affect the tumor microenvironment and areas beyond the irradiated sites. This may enhance the efficacy of ICIs, although their efficacy has only been demonstrated in clinical trials. Full article
(This article belongs to the Special Issue New Insights into Oligo-Recurrence of Various Cancers)
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