Long-term Outcome of Surgery or Stereotactic Radiotherapy for Lung Oligometastases

Lodeweges, J.; Klinkenberg, Theo J.; Ubbels, Jan F.; Groen, Harry J.M.; Langendijk, Johannes A.; Widder, Joachim

doi:10.1016/j.jtho.2017.05.015

Cited by 78 publications

(55 citation statements)

References 5 publications

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“…We read with great interest the article by Lodeweges et al published in the Journal of Thoracic Oncology. 1 The article describes a study of registered patients with pulmonary oligometastases accompanied by controlled primary lesions and other metastases. Even without adjustment using propensity scores, the 5-year overall survival rates were 41% (n ¼ 68) after surgery and 45% (n ¼ 42) after stereotactic radiotherapy, although the patients in latter group were older and had a shorter interval from the primary tumor to first detection of any metastases.…”

Section: To the Editormentioning

confidence: 99%

Long-Term Outcome of Surgery or Stereotactic Radiotherapy for Lung Oligo-recurrence

Niibe

Jingu

Oda

2017

Journal of Thoracic Oncology

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Section: To the Editormentioning

confidence: 99%

Long-Term Outcome of Surgery or Stereotactic Radiotherapy for Lung Oligo-recurrence

Niibe

Jingu

Oda

2017

Journal of Thoracic Oncology

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“…Recently, SBRT came to be widely performed for pulmonary metastasis from various types of cancers, which provides a favorable local control rate. 23 The practice of PM lacks firm evidence, To date, no randomized trials have been conducted comparing PM and other treatment options. 24 Indeed, we have no data on patients with pulmonary metastasis who do not undergo PM, thus a comparison between surgical and non-surgical patients could not be performed in the present study.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Pulmonary Metastasectomy for Uterine Malignancies: A Multi-institutional Study in the Current Era

et al. 2020

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Background. Information on pulmonary metastasectomy (PM) for uterine malignancies in the current era is limited. In the present study, we analyzed the clinical course and results of PM for uterine malignancies in the era of modern imaging diagnostics to clarify the role of PM in the current era in a multi-institutional setting. Methods. Fifty-seven patients who underwent PM for uterine malignancies between 2006 and 2015 were retrospectively reviewed. The short-and long-term outcomes, along with factors associated with the prognosis, were analyzed. Details of the clinical course after PM were described. Results. The mean age of patients was 59.4 years. The primary tumor was located in the uterus corpus in 34 cases (60%) and in the uterus cervix in 23 cases (40%). The median disease-free interval (DFI) was 32 months. Forty patients (70%) received fluorine-18-2-fluoro-2-deoxy-Dglucose positron emission tomography/computed tomography before PM, and complete resection was achieved in 52 patients (91%). Postoperative complications occurred in 4 patients (7%). Of the 52 patients who underwent complete resection of pulmonary metastases, 28 experienced recurrence, and among these, 17 (60%) underwent local therapy, including six repeat PMs. Among the 52 patients who underwent complete resection, the 5-year relapse-free survival rate was 40.7% and the 5-year overall survival (OS) rate was 68.8%. The univariate analysis revealed that a DFI of B 24 months was associated with significantly poorer OS. Conclusions. PM for uterine malignancies is safe and provides favorable long-term outcomes in selected patients. Patients with a DFI of[ 24 months have better OS and are good candidates for PM. Uterine malignancies are the fifth most common type of cancer and the eighth leading cause of death in women in Japan. 1 Uterine malignancies consist of uterine corpus malignancies, which include endometrial cancer that originates from the lining of the uterus; uterine sarcoma, which originates from the muscles or support tissue of the uterus; and cervical cancer. It is reported that the rate of lung metastasis is higher in patients with sarcoma than in patients with epithelial gynecologic cancers. 2-4 Because most tumors in patients with epithelial gynecologic malignancies metastasize to the pelvis, vagina, peritoneum,

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“…Recently, stereotactic body radiation therapy (SBRT) has come to be widely performed for the treatment of pulmonary metastasis, and provides a favorable local control rate. Some radiation oncologists use ''freedom from failure of local control,'' which is similar to TLTF, as an endpoint for SBRT for pulmonary metastasis [19]. We believe that TLTF will be useful in studies comparing pulmonary metastasectomy and SBRT.…”

Section: Discussionmentioning

confidence: 99%

Proposal of a Useful Surrogate Endpoint of the Overall Survival in Patients Undergoing Pulmonary Metastasectomy: The Time to Local Therapy Failure

et al. 2019

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Background A recent study demonstrated remarkable discrepancy between the relapse-free survival (RFS) and overall survival (OS) after pulmonary metastasectomy (PM) in the current era. As the RFS may not be a suitable parameter after PM, a more suitable parameter is needed for PM as a surrogate marker for OS. Methods A total of 134 consecutive patients who underwent PM were retrospectively analyzed. In the present study, we introduced a new endpoint, time to local treatment failure (TLTF). This endpoint was defined as the time interval between the first PM and the first untreatable recurrence by local treatment with curative intent or death due to any cause. We analyzed the correlation between the RFS and OS and between the TLTF and OS to validate whether or not the TLTF is a better parameter than the RFS after PM. Results Thus far, 78 patients have experienced relapse. Of these, 37 patients (47%) underwent local therapy with curative intent, 29 of whom are alive without local treatment failure. The 5-year OS, RFS and TLTF were 70.9%, 36.5%, and 57.6%, respectively. The concordance proportions for the RFS and OS and for the TLTF and OS were 0.634 and 0.851 for all patients, respectively. The Spearman's rank correlation coefficient for the RFS and OS was 0.639, while that for the TLTF and OS was 0.875. Conclusions The TLTF may be a good surrogate parameter for the OS after PM in the current era.

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Long-term Outcome of Surgery or Stereotactic Radiotherapy for Lung Oligometastases

Cited by 78 publications

References 5 publications

Long-Term Outcome of Surgery or Stereotactic Radiotherapy for Lung Oligo-recurrence

Long-Term Outcome of Surgery or Stereotactic Radiotherapy for Lung Oligo-recurrence

Long-Term Outcomes of Pulmonary Metastasectomy for Uterine Malignancies: A Multi-institutional Study in the Current Era

Proposal of a Useful Surrogate Endpoint of the Overall Survival in Patients Undergoing Pulmonary Metastasectomy: The Time to Local Therapy Failure

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