A Review of Metastasis-Directed Therapy in Oligometastatic Gastrointestinal Cancers

Abstract

This review provides an overview of the current understanding regarding the role of metastasis-directed therapy (MDT) in patients with oligometastatic gastrointestinal cancers. A review of clinical data was conducted to describe patient outcomes associated with the use of local therapy alone or in combination with systemic therapy to gastrointestinal oligometastases. Included cancers were esophagus, liver, pancreas, colorectal, and anal canal. Radiotherapy was the most common MDT employed across studies although surgical resection and transarterial ablation were also used. Present data suggest that local therapies should be considered in the treatment of oligometastatic gastrointestinal malignancies for appropriate patients. MDT may be associated with improved overall survival, progression-free survival, particularly for esophageal and colorectal cancers. Enhanced disease control has also been seen for hepatocellular and pancreatic cancers with limited adverse events. The data highlight the increasing impact of locoregional management of oligometastatic disease through multiple treatment modalities. Targeted approaches involving radiotherapy and surgical resection can enhance clinical response to systemic therapy and improve patient outcomes. Future randomized clinical trials will further establish the role of MDT in patients with oligometastatic GI cancers.