Oligometastatic esophagogastric adenocarcinoma per OMEC-1 (OligoMetastatic Esophagogastri...
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | RF-OLIGOMET-DEFINITION |
|---|---|
| Тип | Тривожна ознака |
| Статус | переглянуто 2026-05-08 | очікує клінічного підпису |
| Хвороби | DIS-ESOPHAGEAL DIS-GASTRIC |
| Джерела | SRC-ESMO-ESOPHAGEAL-2024 SRC-ESMO-GASTRIC-2024 SRC-NCCN-ESOPHAGEAL-2025 SRC-NCCN-GASTRIC-2025 SRC-OMEC-1-KROESE-2023 SRC-RENAISSANCE-AIO-FLOT5 |
Походження тривожної ознаки
| Визначення | Oligometastatic esophagogastric adenocarcinoma per OMEC-1 (OligoMetastatic Esophagogastric Cancer) European Delphi consensus (Kroese et al., Eur J Cancer 2023, PMID 36947929). Defined as ≤3 distant metastatic lesions amenable to local therapy in a patient with controllable primary disease and ECOG 0-1 fitness. Excluded scenarios: peritoneal carcinomatosis, leptomeningeal disease, >3 brain metastases. RENAISSANCE / AIO-FLOT5 trial (NCT02578368) eligibility narrower: ≤1 incurable organ-system involvement, no ascites, ≤1 retroperitoneal LN station — uses FLOT chemo ± surgical resection (gastrectomy/oesophagectomy + metastasectomy). Triggers MDT consideration of metastasis-directed local therapy (metastasectomy or SBRT) added to systemic chemo, and registration on RENAISSANCE-pattern trials where available. |
|---|---|
| Клінічний напрям | intensify |
| Категорія | high-risk-biology |
Логіка спрацьовування
{
"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"
}
Нотатки
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...
Де використовується
Algorithms
ALGO-CRC-METASTATIC-1L- ALGO-CRC-METASTATIC-1LALGO-ESOPH-METASTATIC-1L- ALGO-ESOPH-METASTATIC-1LALGO-GASTRIC-METASTATIC-1L- ALGO-GASTRIC-METASTATIC-1L
Indications
IND-ESOPH-OLIGOMET-SYSTEMIC-PLUS-LOCAL- IND-ESOPH-OLIGOMET-SYSTEMIC-PLUS-LOCALIND-GASTRIC-OLIGOMET-SYSTEMIC-PLUS-LOCAL- IND-GASTRIC-OLIGOMET-SYSTEMIC-PLUS-LOCAL
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