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Adenocarcinoma esofagogástrico oligometástico por OMEC-1 (OligoMetastático...

Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.

IDRF-OLIGOMET-DEFINITION
TipoSeñal de alerta
Situaciónreviewed 2026-05-08 | pending_clinical_signoff
EnfermedadesDIS-ESOPHAGEAL DIS-GASTRIC
FuentesSRC-ESMO-ESOPHAGEAL-2024 SRC-ESMO-GASTRIC-2024 SRC-NCCN-ESOPHAGEAL-2025 SRC-NCCN-GASTRIC-2025 SRC-OMEC-1-KROESE-2023 SRC-RENAISSANCE-AIO-FLOT5

Origen de la bandera roja

DefiniciónAdenocarcinoma esofagogástrico oligometástico por OMEC-1 (Cáncer esofagógásico metastásico) Consenso europeo de Delfos (Kroese et al., Eur J Cancer 2023, PMID 36947929). Definido como ≤3 lesiones metastáticas distantes que pueden ser tratadas localmente en un paciente con enfermedad primaria controlable y aptitud ECOG 0-1. Escenarios excluidos: carcinomatosis peritoneal, leptomeningeal, >3 metástasis cerebrales. Ensayo RENAISSANCE / AIO-FLOT5 (NCT02578368) más estrechos: ≤1 involucramiento incurable del sistema de órganos, sin ascite, ≤ 1 estación retroperitoneal LN — utiliza quimio FLOT ± resección quirúrgica (gastrectomía/esofagoctomías + metastasectomía).
Dirección clínicaintensificar
Categoríahigh-risk-biology

Lógica de activación

{
  "all_of": [
    {
      "comparator": "<=",
      "finding": "distant_metastasis_count",
      "threshold": 3
    },
    {
      "comparator": "<=",
      "finding": "ecog_performance_status",
      "threshold": 1
    },
    {
      "finding": "primary_tumor_controllable",
      "value": true
    },
    {
      "finding": "all_metastatic_sites_amenable_to_local_therapy",
      "value": true
    }
  ],
  "none_of": [
    {
      "finding": "peritoneal_carcinomatosis",
      "value": true
    },
    {
      "finding": "leptomeningeal_disease",
      "value": true
    },
    {
      "finding": "brain_metastases_count_gt_3",
      "value": true
    }
  ],
  "type": "composite_score"
}

Notas

OMEC-1 consensus criteria (Kroese et al., Eur J Cancer 2023): 1. ≤3 distant metastatic lesions (primary numerical threshold). 2. Includes metachronous oligo-recurrence ≥6 months after curative- intent treatment. 3. Required diagnostic workup: PET/CT, EUS, brain MRI for symptomatic patients. 4. Required clinical fitness: ECOG 0-1, controllable primary, all metastatic sites amenable to local therapy (metastasectomy or SBRT). 5. Excluded: peritoneal carcinomatosis, leptomeningeal disease, >3 brain metastases. RENAISSANCE / AIO-FLOT5 (NCT02578368) eligibility is narrower than OMEC-1 consensus and represents the trial-grade cutoff: - ≤1 incurable organ-system involvement (e.g. liver-only OR retroperitoneal-LN-only). - No ascites. - ≤1 retroperitoneal lymph-node station. - Adequate response to induction FLOT before randomisation to surgery vs continued FLOT. Local-therapy entities (metastasectomy Surgery, SBRT RadiationCourse) for oligomet are future Phase C extensions — not yet in KB. RF triggers MDT review and routes to oligomet indications which describe sequence in notes/description text rather than typed phases (§17 phases skipped for v0.1; planning doc gi2_wave §4.5 + §17 ratifica...

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