Multidisziplinäre Therapie bei Oligometastasierung von Karzinomen des oberen Gastrointestinaltrakts

Malignancies of the upper gastrointestinal tract with distant metastases (UICC stage IV) are often classified by oncological boards as “palliative” due to the poor prognosis and, thus, patients are consequently not evaluated for surgical therapy. Noteworthy is that oncological stage IV (M1) includes limited oligometastatic disease as well as advanced metastatic disease with multiple distant metastases. However, these two patient groups differ significantly in regard to their oncological prognosis. Over the last decade, clinical trials showed improved prognosis for patients with oligometastatic esophageal or gastric cancer due to improved multimodal treatment concepts with conversion surgery. Due to better systemic treatments and good patient selection, the rate of conversion chemotherapy has continuously increased in recent years. Careful patient selection and choice of multimodal treatment concepts with regular re-evaluation is essential to offer patients the best therapeutic options. Therefore, patients with esophageal or gastric cancer with oligometastatic disease should always be evaluated in high-volume centers to offer patients the best possible treatment and suitable trial participation.