Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Management of oligometastatic cervical cancer: a review of the literature to inform clinical practice guideline development (146451)

Dana Stefanovic 1 , Telma Costa 1 , Susan Elisabeth Yuill 1 , Deborah Bateson AM 1 , Pearly Khaw 2 3 , Jim Nicklin 4 5 , Yee Leung 6 7
  1. Cancer Elimination Collaboration, The University of Sydney, Sydney, NSW, Australia
  2. The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
  3. Peter Mac Division of Radiation Oncology, University of Melbourne, Melbourne, VIC, Australia
  4. Queensland Centre for Gynaecological Cancer, Brisbane, QLD, Australia
  5. University of Queensland, Brisbane, QLD, Australia
  6. Women and Newborn Health Service, Perth, WA, Australia
  7. University of Western Australia, Perth, WA, Australia

Background:
As an intermediate state between localised and widespread metastatic disease, oligometastatic disease (OMD) has distinct prognostic and therapeutic implications. In de novo OMD (at initial presentation), treatment aims to achieve durable disease control and delay systemic therapy escalation, whereas treatment of oligorecurrent disease is influenced by prior treatment, disease-free interval, and metastatic pattern. Multidisciplinary management includes consideration of radical local treatment of the primary tumour and metastases alongside systemic therapy. However, uncertainty remains regarding optimal patient selection, treatment modalities, and sequencing.

Methods:
A review of the literature on treatment of oligometastatic cervical cancer was undertaken to support the development of clinical practice guidelines. Evidence was synthesised to identify key considerations for clinical decision-making.

Results:
Existing international guidelines recommending multidisciplinary, individualised management of oligometastatic cervical cancer are supported mainly by expert consensus and limited evidence. No prospective cervical cancer-specific or comparative studies guiding modality selection or treatment sequencing were identified. Available studies are predominantly radiotherapy-based, particularly evaluating stereotactic body radiotherapy (SBRT), with limited surgical data and no cervical cancer-specific studies on other local ablative therapies found. A pattern-of-care survey of cervical cancer treatment practices within the EMBRACE network demonstrated consensus for pelvic radiotherapy alongside systemic therapy and radiotherapy to metastatic sites in de novo OMD, while highlighting variation in other clinical scenarios. The ESTRO–EORTC oligometastatic disease classification system provides a consensus framework for describing heterogeneous OMD states. In a small retrospective cervical cancer-specific study, classification categories were significantly associated with overall survival.

Conclusions:
OMD represents a heterogeneous clinical state requiring multidisciplinary decision-making that incorporates patient preferences. Careful patient selection and individualised treatment strategies are essential, particularly when considering multimodal approaches with potential for additional morbidity. In the absence of comparative cervical cancer-specific data, classification systems such as the ESTRO–EORTC framework may support structured discussion and complex management considerations.