Oligometastases and oligo-recurrence: the new era of cancer therapy

Yuzuru Niibe, Kazushige Hayakawa, Yuzuru Niibe, Kazushige Hayakawa

Abstract

Recurrence or metastasis of cancer has been considered to occur in the last stage of the patient's life. However, the new notions of oligometastases and oligo-recurrence have been proposed and the paradigm shift in the conceptualization of cancer metastasis or cancer recurrence. Oligometastases is the state in which the patient shows distant relapse in only a limited number of regions. Local therapy such as surgery, radiotherapy and radiofrequency ablation for the relapsed sites could thus improve patient's survival. On the other hand, oligo-recurrence is a notion similar to oligometastases. However, the conditions of oligo-recurrence has a primary site of the cancer controlled, meaning that all gross recurrent or metastatic sites could be treated using local therapy.

Figures

Figure 1.
Figure 1.
This is a schema of oligometastases. Schema 1 shows one distant metastasis/recurrence with a primary lesion. Schema 2 shows two distant metastases/recurrences with a primary lesion.
Figure 2.
Figure 2.
This is a schema of oligo-recurrence. Schema 1 shows one distant metastasis/recurrence with a controlled primary lesion. Schema 2 shows two distant metastases/recurrences with a controlled primary lesion. The biggest difference between oligometastases and oligo-recurrences lies in the uncontrolled or controlled primary lesion. Oligo-recurrence requires a controlled primary lesion.
Figure 3.
Figure 3.
This shows correlations between systemic and local therapies. Until point A, the role of local therapy increases as systemic therapy improves. However, after point A, the role of local therapy decreases as systemic therapy improves, as all cancerous lesions can be cured by systemic therapy at point B.

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