Publications

Journal Article Review Ppublish

PubMed: 41785904 DOI: 10.1016/S1470-2045(25)00714-4

The OligoPanc project: an interdisciplinary expert consensus statement on oligometastatic pancreatic cancer.

Lancet Oncol 27(3):e141-e149

Authors: Carl-Stephan Leonhardt, Mustapha Adham, Shouki Bazarbashi, Irit Ben-Aharon, Regina G H Beets-Tan, Ugo Boggi, Thomas B Brunner, Francesco Cellini, Arturo Chiti, Lois Daamen, Berardino De Bari, Sara De Dosso, Michel Ducreux, Cathy Eng, Massimo Falconi, Cristina R Ferrone, Isabella Frigerio, Ingrid Garajova, Sabine Gerum, Michael Ghadimi, Thomas Gruenberger, Pascal Hammel, Karin Haustermans, Maria Hawkins, Jin He, Hanne D Heerkens, Florence Huguet, Martijn P W Intven, Ulla Klaiber, Tiuri E Kroese, Pierre Laurent-Puig, Florian Lordick, Ethan B Ludmir, Teresa Macarulla, Oscar Matzinger, Alessio G Morganti, Somnath Mukherjee, Eileen M O'Reilly, Joon Oh Park, Demetris Papamichael, Per Pfeiffer, José M Ramia, Falk Roeder, Erika Ruiz-García, Sohei Satoi, Marta Scorsetti, Martin Schneider, Thomas Seufferlein, Alejandro Serrablo, Shailesh V Shrikhande … and 17 other authors

Affiliations

  • Department of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, Austria.
  • Digestive Surgery Department, Lyon Civil Hospital, Lyon, France.
  • Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Alfaisal University, Riyadh, Saudi Arabia.
  • Division of Oncology, Rambam Health Care Center, Haifa, Israel.
  • Department of Radiology, The Netherlands Cancer Institute, Amsterdam, Netherlands.
  • Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
  • Department of Radiation Oncology, Medical University of Graz, Graz, Austria.
  • Department of Radiation Oncology, Fondazione Policlinico Universitario A Gemelli IRCCS Rome, Rome, Italy; Università; Cattolica del Sacro Cuore, Dipartimento Universitario Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy.
  • Department of Nuclear Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht, Netherlands.
  • Radiation Oncology Department, Réseau Hospitalier Neuchâtelois, La Chaux-de-Fond, Switzerland.
  • Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
  • INSERM U1279 and Département de Médecine, Gustave Roussy, Villejuif, France France.
  • Department of Medicine, Division of Hematology and Oncology, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
  • Pancreatic and Transplant Surgery Unit, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
  • Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Hepato-Biliary and Pancreatic Surgery Unit, Pederzoli Hospital, Peschiera del Garda, Italy; Collegium Medicum, SAN University, Lodz, Poland.
  • Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
  • Department of Radiotherapy and Radiation Oncology, Paracelsus Medical University, Salzburg, Austria.
  • Department of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.
  • Department of Surgery, HPB Center, Vienna Health Network, Clinic Favoriten and Sigmund Freud Private University, Vienna, Austria.
  • Department of Digestive and Medical Oncology, Paul Brousse Hospital, University Paris-Saclay, Villejuif, France.
  • Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium.
  • Medical Physics and Biomedical Engineering, University College London, London, UK.
  • Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, Netherlands.
  • Department of Radiation Oncology, Tenon University Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris, France.
  • Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands.
  • Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
  • Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Institut du Cancer Paris CARPEM, Paris, France; Assistance Publique-Hôpitaux de Paris Centre; Department of Biology, Hôpital Européen Georges Pompidou, Paris, France.
  • University Cancer Center Leipzig, University of Leipzig, Leipzig, Germany.
  • Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Gastrointestinal and Endocrine Tumor Unit, Vall d'Hebron University Hospital, Vall d'Hebrón Institute of Oncology, Barcelona, Spain.
  • Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; Clinique de Genolier, Swiss Medical Network, Genolier, Switzerland.
  • Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK.
  • Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
  • Department of Medical Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus.
  • Department of Medical Oncology, Odense University Hospital, Odense, Denmark.
  • Department of Surgery, Hospital General Universitario Dr. Balmis, ISABIAL, Universidad Miguel Hernandez, Alicante, Spain.
  • Department of Radiotherapy and Radiation Oncology, Paracelsus Medical University, Salzburg, Austria; Institute of Research and Development of Advanced Radiation Technologies, Paracelsus Medical University, Salzburg, Austria.
  • Departamento de Tumores de Tubo Digestivo, Instituto Nacional de Cancerología, Tlalpón, Ciudad de México, Mexico.
  • Department of Pancreatobiliary Surgery, Kansai Medical University, Hirakata City, Osaka, Japan; Division of Surgical Oncology, University of Colorado Anschutz, Aurora, CO, USA.
  • Department of Biomedical Sciences, Humanitas University, Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Milan, Italy.
  • Department of General, Visceral, Thoracic and Transplantation Surgery, Giessen University Hospital, Giessen, Germany.
  • Department of Internal Medicine 1, Ulm University Hospital, Ulm, Germany.
  • Department of Surgery, Hospital Universitario Miguel Servet, Zaragoza, Spain.
  • Gastrointestinal and HPB Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.

Abstract

Currently, no consensus exists regarding the definition of oligometastatic pancreatic ductal adenocarcinoma, its necessary diagnostic measures, and potential treatment approaches. To address these knowledge gaps, the OligoPanc project brought together an interdisciplinary group of experts to establish consensus using a modified Delphi process and clinical vignettes. Participants agreed that the number of metastatic lesions and the number of affected organs are key elements in defining oligometastatic pancreatic ductal adenocarcinoma. Specifically, up to three lesions in a single organ, either the liver or the lung, define oligometastatic pancreatic ductal adenocarcinoma and could be either synchronous or metachronous. Necessary diagnostics include a triple-phase contrast-enhanced CT scan of the chest and abdomen and MRI of the liver with a hepatocyte-specific contrast agent. In unclear cases, [ 18F]fluorodeoxyglucose-PET CT or MRI can be considered. A multidisciplinary tumour board is essential. Patient-intrinsic factors, including age, do not define oligometastatic disease but should be considered for any treatment decision. Systemic treatment before any local consolidative treatment, including surgery, stereotactic ablative radiotherapy, or other locally ablative techniques, is mandatory. The proposed definition should be incorporated into future trials to improve comparability and enable validation.

MeSH

Pancreatic Neoplasms, Neoplasms, Adenocarcinoma, Liver, Therapeutics, Wounds And Injuries