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  • Review Article
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The role of local therapy in the management of lung and liver oligometastases

Nature Reviews Clinical Oncology volume 8, pages 405–416 (2011)Cite this article

Subjects

Abstract

Despite recent advances in oncologic therapy, an important proportion of patients with primary cancer will develop distant metastasis. The standard therapy for metastatic cancer is systemic therapy, which typically does not yield excellent response rates for most solid tumors. Data in the literature support the existence of a state of limited metastasis or oligometastasis. Favorable outcomes have been observed in selected patients with oligometastases that are treated with local ablative therapies, which include surgical extirpation, stereotactic body radiation therapy, and radiofrequency ablation. Lung and liver are the two most common sites of oligometastases considered for local ablative therapy and this Review will focus on the role of local therapy in oligometastases that arise in these organs.

Key Points

  • Data in the literature suggest the existence of oligometastasis, a state in which metastases are limited in site and number

  • Different types of local therapies have been used for the treatment of limited metastases, mostly in the lung and liver

  • A large body of data in the literature on metastatectomy in patients with lung and liver oligometastases show that survival can be increased in some patients

  • Data on the use of stereotactic body radiation therapy and radiofrequency ablation are emerging and the early results on local control are promising

  • The biggest challenge is to identify those patients who will benefit from the treatment of their oligometastatic disease with local aggressive therapy

  • The selection of local therapy should involve interdisciplinary discussion among surgeons, radiation oncologists, and medical oncologists, as well as patients

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Figure 1: Resectability of colorectal cancer liver metastases
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Authors and Affiliations

  1. Case Western Reserve University, Cleveland, OH, USA

    Simon S. Lo

  2. Ohio State University Medical Center Columbus, OH, USA

    Susan D. Moffatt-Bruce

  3. University of Toronto, Toronto, ON, Canada

    Laura A. Dawson

  4. University of Texas Southwestern Medical Center, Dallas, TX, USA

    Roderich E. Schwarz

  5. The Methodist Hospital, Houston, TX, USA

    Bin S. Teh

  6. Ohio State University College of Medicine, Columbus, OH, USA

    Nina A. Mayr & John C. Grecula

  7. National University Cancer Institute of Singapore, Singapore

    Jiade J. Lu

  8. Ohio State University College of Medicine, Columbus, OH, USA

    Thomas E. Olencki

  9. University of Texas Southwestern Medical Center, TX, USA

    Robert D. Timmerman

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  1. Simon S. Lo
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  2. Susan D. Moffatt-Bruce
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Contributions

R. D. Timmerman and T. E. Olencki contributed to researching the data for the article and editing the manuscript before submission. B. S. Teh, N. A. Mayr, J. J. Lu and J. C. Grecula contributed to researching the data for the article, discussions of the content and editing the manuscript before submission. S. S. Lo, S. D. Moffatt-Bruce, L. A. Dawson and R. E. Schwarz contributed to researching the data for the article, discussions of the content, writing the article and editing the manuscript before submission.

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Correspondence to Simon S. Lo.

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Competing interests

L. A. Dawson declares associations with the following company and organization: Bayer and the Canadian Institutes of Health and Research. R. D. Timmerman declares associations with the following companies and organization: Varian Medical Systems, Accuray and the US Department of Defense. The other authors declare no competing interests.

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Lo, S., Moffatt-Bruce, S., Dawson, L. et al. The role of local therapy in the management of lung and liver oligometastases. Nat Rev Clin Oncol 8, 405–416 (2011). https://doi.org/10.1038/nrclinonc.2011.75

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