The management of oligometastatic disease in colorectal cancer: Present strategies and future perspectives

• Published in: Critical reviews in oncology/hematology 2023-06, Vol.186, p.103990-103990, Article 103990
• Main Authors: Carconi, Catia, Cerreti, Micaela, Roberto, Michela, Arrivi, Giulia, D’Ambrosio, Giancarlo, De Felice, Francesca, Di Civita, Mattia Alberto, Iafrate, Franco, Lucatelli, Pierleone, Magliocca, Fabio Massimo, Picchetto, Andrea, Picone, Vincenzo, Catalano, Carlo, Cortesi, Enrico, Tombolini, Vincenzo, Mazzuca, Federica, Tomao, Silverio
• Format: Article
• Language: English
• Subjects: Brachytherapy; Colorectal cancer (CRC); Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - pathology; Colorectal Neoplasms - therapy; Humans; Oligometastatic disease (OMD); Radiofrequency ablation (RFA); Radiosurgery - methods; Selective internal radiotherapy (SIRT); Stereotactic body radiation therapy (SBRT); Trans-arterial chemoembolization (TACE)
• ISSN: 1040-8428; 1879-0461
• DOI: 10.1016/j.critrevonc.2023.103990

Oligometastatic disease has been described as an intermediate clinical state between localized cancer and systemically metastasized disease. Recent clinical studies have shown prolonged survival when aggressive locoregional approaches are added to systemic therapies in patients with oligometastases. The aim of this review is to outline the newest options to treat oligometastatic colorectal cancer (CRC), also considering its molecular patterns. We present an overview of the available local treatment strategies, including surgical procedures, stereotactic body radiation therapy (SBRT), thermal ablation, as well as trans-arterial chemoembolization (TACE) and selective internal radiotherapy (SIRT). Moreover, since imaging methods provide crucial information for the early diagnosis and management of oligometastatic CRC, we discuss the role of modern radiologic techniques in selecting patients that are amenable to potentially curative locoregional treatments. [Display omitted] •Oligometastatic colorectal cancer represents a disease with an intermediate prognosis.•In addition to surgery, radiation and radiological therapy have shown to improve the benefit of systemic chemotherapy, prolonging survival.•Considering the mutational profile of colorectal cancer metastases could help propose a locoregional treatment.•Although prospective randomized studies are still few, combining systemic chemotherapy and locoregional strategies may further increase patients’ outcome