Locoregional treatment of esophageal oligometastatic disease to the liver: single center experience, a systematic review and meta-analysis
Menée à l'aide de données monocentriques portant sur 11 patients et menée à partir d'une revue systématique de la littérature et de deux méta-analyses, cette étude évalue le rôle des thérapies locorégionales dans le traitement des métastases hépatiques ayant pour origine un cancer de l'oesophage
Background: The prognosis of patients with esophageal cancer remains poor, even more when distant metastases are present. Despite the recent advances in definition and diagnosis of oligometastatic disease (OMD), consensus on the treatment of this condition has not been established. The aim of the study is to describe our center experience and to compare it to the existing literature.
Materials and Methods: Patients with esophageal cancer, treated with locoregional therapies for liver metastases between 2010 and 2023, were retrospectively analyzed. Data on demographics, treatment, overall survival (OS), and disease-free survival (DFS) were collected. A systematic review and two meta-analyses were performed in accordance with the PRISMA 2020 guidelines: a meta-analysis of proportions and a comparative effectiveness meta-analysis to compare 1-year OS between locoregional therapies and systemic therapy alone.
Results: Eleven patients were treated with locoregional therapies. The overall median OS and DFS were 27 months and 16 months, respectively. A meta-analysis of proportions estimated a 1-year OS rate of 57% (95% CI: 45%-68%) with moderate heterogeneity (I2 = 49%). A meta-analysis of comparative effectiveness documented a significant survival advantage for locoregional therapies over systemic therapy alone (odds ratio: 0.12 [95% CI: 0.04-0.37], p < 001), again strongly supporting their role in this setting.
Conclusion: Our findings show that locoregional treatments may offer a survival benefit for oligometastatic liver disease from esophageal cancer, especially in the context of multimodal therapeutic approach. Results are aligned with current literature. Future studies should be designed as large, multicenter, randomized trials that confirm the efficacy of such treatments.
European Journal of Surgical Oncology , résumé, 2025