Solitary sites of metastatic disease in non-small cell lung cancer

Abstract

Metastatic (stage IV) non-small cell lung cancer is a lethal disease, with few patients surviving longer than 5 years. Surgery is not an option, and adjuvant therapy regimens (platinum-based chemotherapy, radiation therapy, and supportive care) have been structured around palliation and maximizing the quality of life for patients. However, patients with solitary foci of metastatic disease represent a subgroup with a better prognosis. Studies have indicated that surgical resection may enhance the survival rate of patients in this setting. Patients who have resectable primary tumors and a solitary site of metastasis, based on a thorough metastatic work-up, benefit from surgical resection (primary tumor and solitary metastasis). The role of adjuvant chemotherapy and radiation depends on the individual and patient setting. There have been several case series indicating an improvement in the long-term (5-year) survival rates of patients after surgical resection of solitary metastases of the brain, adrenal gland, and other sites. Prospective trials will be required to determine the magnitude of benefit of surgical resection for patients and the role of multimodality therapy. The standard of care for patients with solitary metastases in non-small cell lung cancer should include consideration of surgical resection and ablation. Favorable criteria include control of the primary tumor, a negative metastatic survey, good performance status, and a significant metachronous interval.

Metachronous adrenal masses in resected non-small cell lung cancer patients: therapeutic implications of laparoscopic adrenalectomy

“…Moreover, it has been claimed that a laparoscopic exploration can also be necessary in order to confirm both the neoplastic nature of the lesion and the feasibility of the operation [4]. Adrenal gland is a common site of metastasis from lung carcinoma but rarely the patients are suitable to a surgical resection [5][6]. Despite that some long-term survivors of resection of a solitary adrenal metastasis from NSCLC are reported in the literature [7][8][9][10][11].…”

Analysis of Prognostic Factors in Stage IIIB-IV Non-Small Cell Lung Cancer Cases who Received Chemotheraphy

“…Soliter beyin metastazlarında ve böbreküstü bezi metastazlarında lokal kontrol terapisi amacıyla uygulanan cerrahinin ve beyin metastazlarında ilave olarak uygulanan radyoterapi ile KHDAK olgularda uzun süreli yaşam sağlanabilir [17,19]. Çalışmamızda ise, beyin, karaciğer, karşı akciğer ve böbreküstü metastazları ile sağ kalım arasında korelasyon kurulamazken kemik metastazlarının yaşam süresini kısalttığı görülmüştür.…”

Laparoscopic adrenalectomy for metastatic adrenal cancer with vena cava inferior resection

“…[1,2] Adrenal gland is a common site of metastasis from lung carcinoma. [2,3] Laparoscopic adrenalectomy for metastatic adrenal cancer is technically difficult. Because usually diagnosed at an advanced stage with invasion of or adherence to the liver, kidney, inferior vena cava (VCI), spleen and pancreas.…”