Pooled analysis for surgical treatment for isolated adrenal metastasis and non-small cell lung cancer

Gao, Xinliang; Zhang, Kewei; Tang, Mingbo; Zhang, Kejian; Fang, Linan; Liu, Wei

doi:10.1093/icvts/ivw321

Cited by 42 publications

(35 citation statements)

References 29 publications

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“…LCC and lymph node metastasis are factors of poor prognosis . For patients with synchronous isolated adrenal metastatic NSCLC, the median OS after lung surgery and complete adrenalectomy was 12 months, and the five‐year survival rate was around 20% . Adrenal metastasis has more significant benefits than other oligometastasis for comprehensive treatment of combined surgery, without significant difference among various pathological types .…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and prognosis of pulmonary large cell carcinoma: A population‐based retrospective study using SEER data

Liu

Zhang

et al. 2020

Thoracic Cancer

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Background: Pulmonary large cell carcinoma (LCC) is an infrequent neoplasm with a poor prognosis. This study explored the clinical characteristics and survival prognostic factors of LCC patients. Methods: Patient data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Chi-square tests or rank-sum tests were used to compare differences in clinical characteristics. Log-rank tests, univariate, and multivariate analyses were performed to investigate the independent factors of survival. Analyses of stage I-IV patients were performed to further explore the optimal treatment. Results: In total, 3197 LCC patients were included in this analysis. Compared with other non-small cell lung cancers (NSCLCs), there was a worse overall survival (OS) from LCC. LCC was more common in males, over age 60 and in the upper lobe. A total of 73.6% of patients were stage III/IV. The median OS of stage I-IV patients was 42 months, 22 months, 11 months, and three months, respectively. The elderly, males, later stage, and main bronchus location, or overlapping lesions were risk factors for survival prognosis. In stage I-III patients, treatment including surgery could significantly reduce the risk of death by 60% at least compared with no therapy. Surgery was still beneficial for stage IV patients, and the hazard ratio (HR) compared with no therapy was 0.462 (P = 0.001). Conclusions: Our study concluded that LCC has unique clinical features, and that age, sex, primary site, stage, and treatment are significantly related to OS. Surgery based comprehensive treatments are effective for LCC.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and prognosis of pulmonary large cell carcinoma: A population‐based retrospective study using SEER data

Liu

Zhang

et al. 2020

Thoracic Cancer

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“…35 Two-year OS after surgery in Gao et al's pooled analysis was 40.5%, and 5-year OS was 28.2% (n=98 patients). 48 Tanvetyanon et al described 25% 5-year OS (n=10 studies; 114 patients), 49 while Beitler et al reported approximately one-third of patients as five-year survivors.…”

Section: Discussionmentioning

confidence: 99%

“…35 Three of these four papers were restricted to surgical results in lung cancer, [48][49][50] with Gunjur and colleagues analyzing surgery (n=30 studies) and ablative RT (n=9) for adrenal OM from all primary tumor sites. 35 Gunjur et al reported a weighted 2-year OS of 46% for adrenalectomy versus 19% for SBRT, and 2-year local control (LC) of 84% versus 63% respectively.…”

Section: Discussionmentioning

confidence: 99%

“…73 Some authors advocate the "test of time" approach in synchronous presentations, utilizing systemic therapy (cytotoxic chemotherapy or targeted agents) for 3-12 months, to allow the natural history of the disease to declare itself. 21,26,33,48,59 If, after that period, no evidence of spread is evident on thorough clinical and radiologic reassessment, tumor biology can be considered favorable and aggressive therapy may be entertained. 48,59 Eligibility criteria for a laparoscopic approach have been suggested as: tumor <5-6 cm, 20 54 and no significant adhesions from prior surgery or trauma.…”

Section: Recommendationsmentioning

confidence: 99%

“…21,26,33,48,59 If, after that period, no evidence of spread is evident on thorough clinical and radiologic reassessment, tumor biology can be considered favorable and aggressive therapy may be entertained. 48,59 Eligibility criteria for a laparoscopic approach have been suggested as: tumor <5-6 cm, 20 54 and no significant adhesions from prior surgery or trauma. 54 Adjuvant systemic therapy should be considered for patients with good functional status to address micrometastatic disease, 33,50,71,75 acknowledging that the optimal duration is not defined and the level of supporting evidence is weak.…”

Section: Recommendationsmentioning

confidence: 99%

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Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

Thomsen¹,

Fairchild²

2017

Oncology &Amp; Hematology Review (US)

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B ackground: Five-year overall survival (OS) for patients with stage IV non-small cell lung cancer (NSCLC) is a dismal 1%. However, approximately 7% have limited or solitary metastases, including to the adrenal gland. Radical treatment of these oligometastases (OM) could increase local control and improve OS. Our objective was to critically analyze data describing aggressive treatment of adrenal OM secondary to NSCLC. Methods: A literature search examining English publications describing surgery or radiotherapy (RT) was performed, supplemented by searching reference lists. Case reports of three or fewer patients, and articles from which NSCLC-or adrenal-specific clinical outcomes could not be abstracted, were excluded. Results: Twenty-nine studies met eligibility criteria (521 patients), 26 retrospective. No publications directly compare modalities. Four surgery studies described contemporaneous patients treated with palliative chemotherapy (CH) alone. Reported median OS ranged from 9.5-64 months after adrenalectomy, 8-23 months after RT, and 6-8.5 months after CH. Local failure after surgery was 14%, with response rates after RT 57-75%. Both appear well-tolerated. Conclusions: In patients with an adrenal OM secondary to NSCLC, aggressive treatment should be considered. However, due to the paucity of high quality evidence, it is unclear at present whether this approach alters the natural history of the disease.

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

Sonoda

Matsuura

Kondo

et al. 2021

Journal of Surgical Oncology

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Background and Objectives: The effectiveness of local therapy has been reported in non-small-cell lung cancer (NSCLC) patients with oligo-recurrence. However, there is still no clear consensus on the choice of local therapy. We aimed to examine the choice of local therapy in NSCLC patients with lung oligo-recurrence.Methods: Among 1760 consecutive NSCLC patients who underwent complete resection between 1990 and 2008, 535 patients developed recurrence. Lung oligorecurrence was defined as 1-5 metachronous recurrences limited to the lungs only; such recurrence was found in 97 patients. We examined the differences in the prognosis of each therapy for these patients. Results:The 5-year postrecurrence survival (PRS) rates in patients who underwent local therapy (n = 54) and those who did not (n = 43) were 55.6% and 31.1%, respectively; it was significantly higher in patients who underwent local therapy (p = 0.004). Among 47 patients who underwent resection or radiation therapy, the 5-year PRS rates were 61.5% and 47.6% (p = 0.258), and the 5-year postrecurrence progression-free survival rates were 30.3% and 24.7% (p = 0.665), respectively, without any significant difference. Conclusions: Patients with lung oligo-recurrence should consider local therapy individually, depending on their general condition.

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Pooled analysis for surgical treatment for isolated adrenal metastasis and non-small cell lung cancer

Abstract: NSCLC patients with isolated adrenal metastasis undergoing surgical treatment for the primary tumour and adrenal metastasis could achieve a significant survival benefit, especially if they have metachronous adrenal metastasis or are negative for lymph node metastasis.

Cited by 42 publications

References 29 publications

Clinical characteristics and prognosis of pulmonary large cell carcinoma: A population‐based retrospective study using SEER data

Clinical characteristics and prognosis of pulmonary large cell carcinoma: A population‐based retrospective study using SEER data

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

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

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