Panel deliberation.
End of chemo-radiation therapy evaluation shows residual mass in one third of patients. End of therapy residual mass is often non-viable; resection of such mass is not associated with improved local control or overall survival. Moreover, such resection often fails to achieve complete resection and is associated with increased complications25,27,41-48. However, DPE, a pre-planned part of the initial treatment strategy, should be considered when feasible24,25,26.
The panel suggests local treatment of residual metastatic disease after completion of chemotherapy. (Weak recommendation; Certainty of evidence: Very Low)
No comparative studies assessed resection of residual metastatic disease after completion of chemotherapy compared to no resection of residual metastatic disease.