Comparison of local therapy in patients with lung oligo‐recurrence of non‐small‐cell lung cancer

Sonoda, Dai; Matsuura, Yuichiro; Kondo, Yasuto; Ichinose, Junji; Nakao, Masayuki; Ninomiya, Hironori; Nishio, Makoto; Okumura, Sakae; Satoh, Yukitoshi; Mun, Mingyon

doi:10.1002/jso.26453

Cited by 7 publications

(8 citation statements)

References 22 publications

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“…Although minimally invasive surgery has increased the procedure's safety [ 12 , 13 ], the loss of respiratory function after surgery significantly impacts the quality of life and decreases chemotherapy rates. In recent years, local consolidative therapy for oligometastasis and oligo-recurrence has attracted considerable attention in the field of cancer of various organs [ 14 , 15 ]. The two-step evaluation may be useful in determining the indications for such treatment.…”

Section: Discussionmentioning

confidence: 99%

Optimal timing for lung metastasectomy in patients with colorectal cancer

Ichinose

Hashimoto

Matsuura

et al. 2022

Interactive CardioVascular and Thoracic Surgery

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Objectives The possibility of occult metastasis remains a concern when deciding on lung metastasectomy. This study aimed to evaluate the utility of our two-step determination, which required confirmation that no new metastases had occurred over three months before surgery. Methods Patients who were referred for colorectal lung metastases between 2007 and 2015 were reviewed. Immediate wedge resection was performed for cases with a single peripheral metastasis, whereas surgical indications for others were determined by the two-step determination. Early increase was defined as the emergence of new metastases within four months after diagnosis of lung metastases. Results Among 369 patients included, 92 were unresectable upon initial diagnosis, and 74 with single peripheral metastasis underwent immediate wedge resection. Surgical indications for the remaining 203 patients were ascertained based on the two-step determination. Surgery was not indicated in 48 patients (24%) due to new metastases or a favourable response to chemotherapy, with a median waiting duration of 4.8 months. Those who did not receive surgery had a worse prognosis than those who did (five-year overall survival: 21% vs 69%, p < 0.001) and were comparable to the initially unresectable group (five-year overall survival: 23%). Thirty-eight patients with early increase had lower surgical resection rates and worse prognoses than those without. Multivariable analysis identified early increase as an independent prognostic factor (hazard ratio: 4.49, p < 0.001). Conclusion Patients with colorectal lung metastasis who developed new metastasis during the waiting period exhibited poor prognosis, suggesting the utility of the two-step determination of surgical indications.

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Section: Discussionmentioning

confidence: 99%

Optimal timing for lung metastasectomy in patients with colorectal cancer

Ichinose

Hashimoto

Matsuura

et al. 2022

Interactive CardioVascular and Thoracic Surgery

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“…Research by S onoda et al . [ 62 ] illustrated a significantly higher 5-year post-recurrence survival (PRS) rate of 55.6% for patients undergoing LAT versus 31.1% without, underlining LAT's efficacy. Although some prospective trials exist for OMD, evidence for oligorecurrence mainly relies on retrospective studies, demonstrating the need for more prospective trials ( table 2 ) [ 51 , 52 , 60 , 66 ].…”

Section: Oligorecurrencementioning

confidence: 99%

“…The choice of treatment modality for oligorecurrent NSCLC remains a subject of ongoing discussion and may vary based on the metastatic site and patient factors. In a retrospective study with 97 patients with oligorecurrent pulmonary NSCLC, surgical resection trended towards improved 5-year PRS and post-recurrence PFS compared to radiation therapy, although this was not statistically significant [ 62 ]. Additionally, significantly longer PRS for surgical resection has been reported when compared to nonoperative therapy with a similar cohort [ 54 , 67 ].…”

Section: Oligorecurrencementioning

confidence: 99%

“…However, secondary surgery for oligorecurrent lesions in the chest may be challenging because of anatomical changes, higher complication rates and patient surgery-fatigue [ 58 ]. Furthermore, some patients may not be eligible for surgery owing to poor general condition or limited respiratory function [ 62 ]. In such cases, local radiotherapy with or without chemotherapy is an alternative treatment option [ 58 ].…”

Section: Oligorecurrencementioning

confidence: 99%

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Complex situations in lung cancer: multifocal disease, oligoprogression and oligorecurrence

Werner,

Steinmann,

Decaluwe

et al. 2024

Eur Respir Rev

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With the emergence of lung cancer screening programmes and newly detected localised and multifocal disease, novel treatment compounds and multimodal treatment approaches, the treatment landscape of non-small cell lung cancer is becoming increasingly complex. In parallel, in-depth molecular analyses and clonality studies are revealing more information about tumorigenesis, potential therapeutical targets and the origin of lesions. All can play an important role in cases with multifocal disease, oligoprogression and oligorecurrence. In multifocal disease, it is essential to understand the relatedness of separate lesions for treatment decisions, because this information distinguishes separate early-stage tumours from locally advanced or metastatic cancer. Clonality studies suggest that a majority of same-histology lesions represent multiple primary tumours. With the current standard of systemic treatment, oligoprogression after an initial treatment response is a common scenario. In this state of induced oligoprogressive disease, local ablative therapy by either surgery or radiotherapy is becoming increasingly important. Another scenario involves the emergence of a limited number of metastases after radical treatment of the primary tumour, referred to as oligorecurrence, for which the use of local ablative therapy holds promise in improving survival. Our review addresses these complex situations in lung cancer by discussing current evidence, knowledge gaps and treatment recommendations.

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“…Surgery is a potent curative tool for managing cancers, however, local recurrence has remained a clinically significant problem in most cancer types ( 2 – 4 ). Local recurrence rates could be as high as about 85% ( 5 ) for ovarian cancer, or 30% in non-small cell lung cancer (NSCLC) ( 6 , 7 ) and as low as between 8% ( 8 ) to 16.5% ( 9 ) in breast cancer. Advanced surgical techniques, chemotherapy, radiotherapy ( 4 ) as well as endocrine therapy ( 10 ) are being used to minimize locoregional recurrence but “minimal” improvements and treatment-related mortality has highlighted the need for a better understanding and strategy for local recurrence ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

Computational modeling of locoregional recurrence with spatial structure identifies tissue-specific carcinogenic profiles

2023

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IntroductionLocal and regional recurrence after surgical intervention is a significant problem in cancer management. The multistage theory of carcinogenesis precisely places the presence of histologically normal but mutated premalignant lesions surrounding the tumor - field cancerization, as a significant cause of cancer recurrence. The relationship between tissue dynamics, cancer initiation and cancer recurrence in multistage carcinogenesis is not well known.MethodsThis study constructs a computational model for cancer initiation and recurrence by combining the Moran and branching processes in which cells requires 3 or more mutations to become malignant. In addition, a spatial structure-setting is included in the model to account for positional relativity in cell turnover towards malignant transformation. The model consists of a population of normal cells with no mutation; several populations of premalignant cells with varying number of mutations and a population of malignant cells. The model computes a stage of cancer detection and surgery to eliminate malignant cells but spares premalignant cells and then estimates the time for malignant cells to re-emerge.ResultsWe report the cellular conditions that give rise to different patterns of cancer initiation and the conditions favoring a shorter cancer recurrence by analyzing premalignant cell types at the time of surgery. In addition, the model is fitted to disease-free clinical data of 8,957 patients in 27 different cancer types; From this fitting, we estimate the turnover rate per month, relative fitness of premalignant cells, growth rate and death rate of cancer cells in each cancer type.DiscussionOur study provides insights into how to identify patients who are likely to have a shorter recurrence and where to target the therapeutic intervention.

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Comparison of local therapy in patients with lung oligo‐recurrence of non‐small‐cell lung cancer

Cited by 7 publications

References 22 publications

Optimal timing for lung metastasectomy in patients with colorectal cancer

Optimal timing for lung metastasectomy in patients with colorectal cancer

Complex situations in lung cancer: multifocal disease, oligoprogression and oligorecurrence

Computational modeling of locoregional recurrence with spatial structure identifies tissue-specific carcinogenic profiles

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