157 Descriptive Analysis of the Current Management and Outcomes of Oligometastatic Oesophageal and Gastric Cancer – a Single Centre Experience

Abstract Background Oligometastatic oesophageal and gastric (OG) cancers are a distinct clinical entity with emerging evidence supporting aggressive local treatment alongside systemic therapy. However, data on real-world outcomes remain limited. This study aimed to evaluate the current management strategies and outcomes of patients with oligometastatic OG cancer at a UK tertiary referral centre, using the newly established OMEC-4 criteria. Method A retrospective cohort analysis was conducted from January 2020 to January 2024. Patients were categorised into oligometastatic and polymetastatic groups based on the OMEC-4 definition. Demographics, tumour characteristics, treatment modalities, and survival outcomes were analysed and compared between groups. Results Among 82 patients with metastatic OG cancer, 27 (32.9%) were classified as oligometastatic. Oesophageal cancer was more prevalent in the oligometastatic group (81.5% vs. 54.5%, p=0.038). Bone and lymph node metastases were significantly more frequent in oligometastatic patients (p=0.010 and p=0.001, respectively). Systemic therapy was administered in 48.1% of oligometastatic patients, with limited application of local therapies. No significant differences in overall survival were observed between groups (median 13.5 vs. 8.6 months, p=0.118). Conclusions Oligometastatic OG cancer represents a notable proportion of metastatic presentations. While differences in metastatic patterns were observed, current management largely mirrors that of polymetastatic disease, with limited utilisation of local therapies. These findings highlight the need for integrating emerging evidence and guidelines into routine practice to optimise outcomes in this subgroup.