Oligo-Recurrence in Lung Cancer; The Most Curable State Among Advanced Disease?

The introduction of effective systemic therapies, such as immune checkpoint inhibitors and molecular-targeted agents, along with advancements in precision medicine, has significantly improved survival outcomes for patients with advanced non-small-cell lung cancer (NSCLC). However, recurrence or progression remains common, and only a fraction of patients can achieve long-term control. For a subset of patients with more localized metastatic disease—referred to as oligometastases—emerging evidence suggests that a multimodal approach combining systemic therapy with local ablative therapies (LAT), such as radiotherapy or surgical resection, may offer curative potential. The concept of oligo-recurrence is defined by the presence of a limited number of metastases and recurrences in patients with controlled primary lesions. A key distinction between oligometastasis and oligo-recurrence lies in the status of the primary lesion: whether it is controlled or uncontrolled. In cases of oligo-recurrence, all gross recurrent or metastatic sites are potentially treatable with LAT. According to a European consensus, oligo-recurrence is regarded as the most favorable subgroup among various oligometastatic classifications, showing a promising response to LAT. However, this classification remains a topic of ongoing debate and requires further exploration. In addition to an ongoing randomized clinical trial on oligo-recurrent NSCLC, further rigorous studies focusing specifically on oligo-recurrence could help refine treatment strategies for this advanced but potentially curable state. These investigations are essential for developing effective, tailored approaches to optimize outcomes for patients within this prognostically favorable subgroup.