Treatment outcomes in oligometastatic non‐small‐cell lung cancer: A single‐centre experience

Abstract

BackgroundEven in oligometastatic stage 4 disease, survival rates are higher when curative approaches focus on both the primary tumour and metastasis. So, we aim to analyse our results of oligometastatic disease retrospectively.MethodsIn total, data on 52 non‐small‐cell lung cancer (NSCLC) patients with limited metastasis (one to three synchronous/metachronous) were retrospectively analysed. All treatment modalities associated with various treatment modalities [surgery, chemoradiotherapy (CRT), supportive care and palliative chemotherapy] were compared in terms of survival. Curative treatment consisted of surgery or CRT (concurrent or sequential).ResultsThe median overall survival (OS) time was 35.2 ± 4.1 months. Surgery was superior to CRT in terms of OS (36.7 months vs 27.4 months, P > 0.05). Progression‐free survival was 29.4 ± 3.9 months, and survival after first progression (SAFP) was 15.6 ± 2.8 months. Patients in whom a metastasectomy was performed had significantly higher rate of SAFP as compared with those who did not have a metastasectomy (20.07 ± 3.8 months vs 7.9 ± 1.7 months P = 0.046). According to pathological type, an adenocarcinoma was associated with better SAFP than a non‐adenocarcinoma (23 ± 4.1 vs 6.4 ± 1.5, P = 0.002). The 1‐ and 2‐years OS rates were 67% and 50.4%, respectively. Among the curative treatment group, the OS of patients younger than 65 years (n = 25) was 31 months, whereas that of patients older than 65 years (n = 13) was 22 months (P = 0.88).ConclusionIn well‐selected NSCLC patients with limited metastasis, survival rates can reach up to 3 years, even in a geriatric population. Clinical N staging and co‐morbidity are important prognostic factors.

Retracted: Clinical effect of surgical treatment for lung metastasis and prognostic risk factor analysis: a single‐centred cohort study

“…In this study, the 3‐ and 5‐year OS rates of 165 patients with lung metastases were 60.0% and 34.3%, respectively. The DFS rates were 39.4% and 23.7%, respectively, and the median survival time was 24.0 months, which was similar to those of previous studies 4–6,11 …”

“…If surgical intervention is selected in the stage of 'oligometastasis', patients may achieve 'cure' effect. [3][4][5][6]9 A retrospective study in Japan concluded that surgical treatment was superior to chemotherapy alone; after PM, the 5-and 10-year survival rates of patients with pulmonary metastases were 35-70% and 20-30%, respectively. However, the 5-year survival rate of patients treated with drugs alone is only 20%.…”

“…The lungs are supplied by the pulmonary and bronchial arteries, and their blood pressure is relatively low, which makes the lungs a common site of malignant tumour blood metastasis 2 . Since Davis reported the first pulmonary metastasectomy (PM) in 1927, major centres worldwide have reported that surgical resection of lung metastases can improve the survival rate of specific patients, including long‐term survival 3–6 . According to statistics, more than 75% of patients with pulmonary metastases have extrathoracic metastases, and only 15% and 25% of patients have localized pulmonary metastases that can be treated by radical surgery 7 .…”

“…2 Since Davis reported the first pulmonary metastasectomy (PM) in 1927, major centres worldwide have reported that surgical resection of lung metastases can improve the survival rate of specific patients, including long-term survival. [3][4][5][6] According to statistics, more than 75% of patients with pulmonary metastases have extrathoracic metastases, and only 15% and 25% of patients have localized pulmonary metastases that can be treated by radical surgery. 7 In 2019, the American Association for Thoracic Surgery released an expert consensus on lung metastases.…”

Oligometastatic Disease in Non-Small-Cell Lung Cancer: An Update

“…The study highlighted the possibility of long-term survival benefit in selected NSCLC patients with extra-cranial extra-adrenal oligometastases following metastatectomy. In line with the study, one original article also demonstrated the importance of nodal stage as a prognostic factor and the survival benefit of local ablative treatments in selected advanced-stage NSCLC patients with median OS of 35.2 months [ 135 ]. However, the efficacy of LCT for the treatment of NSCLC patients with liver oligometastases could not be drawn from the two studies due to relatively small sample size and various clinical outcomes.…”