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.