Cancer Res Treat.  2023 Oct;55(4):1281-1290. 10.4143/crt.2023.479.

Differential Perspectives by Specialty on Oligometastatic Colorectal Cancer: A Korean Oligometastasis Working Group’s Comparative Survey Study

• Cho WK
• Yoo GS
• Rim CH
• Jeong JU
• Chie EK
• Ahn YC
• Cho HM
• Um JW
• Suh YG
• Chang AR
• Lee JH
• On behalf of the Oligometastasis Working Group, Korean Cancer Association

• KMID: 2547802
• DOI: http://doi.org/10.4143/crt.2023.479

Abstract

Purpose
Despite numerous studies on the optimal treatments for oligometastatic disease (OMD), there is no established interdisciplinary consensus on its diagnosis or classification. This survey-based study aimed to analyze the differential opinions of colorectal surgeons and radiation oncologists regarding the definition and treatment of OMD from the colorectal primary.
Materials and Methods
A total of 141 participants were included in this study, consisting of 63 radiation oncologists (44.7%) and 78 colorectal surgeons (55.3%). The survey consisted of 19 questions related to OMD, and the responses were analyzed using the chi-square test to determine statistical differences between the specialties.
Results
The radiation oncologists chose “bone” more frequently compared to the colorectal surgeons (19.2% vs. 36.5%, p=0.022), while colorectal surgeons favored “peritoneal seeding” (26.9% vs. 9.5%, p=0.009). Regarding the number of metastatic tumors, 48.3% of colorectal surgeons responded that “irrelevant, if all metastatic lesions are amendable to local therapy”, while only 21.8% of radiation oncologist chose same answer. When asked about molecular diagnosis, most surgeons (74.8%) said it was important, but only 35.8% of radiation oncologists agreed.
Conclusion
This study demonstrates that although radiation oncologists and colorectal surgeons agreed on a majority of aspects such as diagnostic imaging, biomarker, systemic therapy, and optimal timing of OMD, they also had quite different perspectives on several aspects of OMD. Understanding these differences is crucial to achieving multidisciplinary consensus on the definition and optimal management of OMD.

Keyword

Oligometastasis; Colorectal neoplasms; Radiation oncologists; Colorectal surgeon

Figure

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  Fig. 1 Recommended total dose for lung metastasis from colon and rectum in 10-fractions (A) and 4-fractions (B) scheme.

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  Fig. 2 Recommended total dose for liver metastasis from colon and rectum in 10-fractions (A) and 4-fractions (B) scheme.

Reference

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