Format

Send to

Choose Destination
Ann Thorac Surg. 2019 Apr;107(4):1053-1059. doi: 10.1016/j.athoracsur.2018.10.029. Epub 2018 Nov 23.

Synchronous Oligometastatic Lung Cancer Deserves a Dedicated Management.

Author information

1
Department of Thoracic Surgery, Paris Center University Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France; Department of Radiotherapy, Hopital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France.
2
Department of Thoracic Surgery, Paris Center University Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France.
3
Department of Pathology, Paris Center University Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France.
4
Thoracic Oncology Unit, St. Joseph Hospital, Paris Descartes University, Paris, France.
5
Department of Thoracic Surgery, Paris Center University Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France. Electronic address: marco.alifano@aphp.fr.

Abstract

BACKGROUND:

Oligometastatic stage IV non-small lung cancer (NSCLC) patients have a 5-year overall survival of 30% versus 4% to 6% in historical cohorts of stage IV NSCLC patients. We reviewed data and patterns of care of patients affected by oligometastatic NSCLC in our center between 2001 and 2017.

METHODS:

We retrospectively reviewed clinical and pathological files of all patients with lung cancer and synchronous isolated adrenal or brain metastases, or both, treated by locally ablative treatments (surgery or radiotherapy, or both) of both primary cancer and distant metastasis. Statistical analysis was performed to assess the effect on overall survival of patient- and tumor-related characteristics and therapeutic approaches. Overall survival was assessed by the Kaplan-Meier method. Survival rates were compared by log-rank test. Significance was accepted at a level of p of less than 0.05.

RESULTS:

Our department treated 51 patients affected by NSCLC and synchronous brain metastasis (n = 41), adrenal metastasis (n = 9), or both (n = 1). Median survival was 42 months (95% confidence interval, 22.3 to 63.7). Overall survival was 62% at 2 years and 34.4% at 5 years. A univariate and multivariate analysis the positive prognostic factors for survival was cessation of smoking (p = 0.006) and lymphovascular and perineural spreading in the tissues (p = 0.024).

CONCLUSIONS:

In selected oligometastatic synchronous NSCLC patients, a multimodality approach encompassing radical treatment of the primary tumor and ablative treatment of concurrent metastases is recommended, with encouraging results. Smoking cessation is a part of the treatment sequence.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center