How to handle oligometastatic disease in nonsmall cell lung cancer

Eichhorn, Florian; Winter, Hauke

doi:10.1183/16000617.0234-2020

Cited by 3 publications

(3 citation statements)

References 111 publications

(113 reference statements)

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“…Notably, the influence of N stage on patient survival was well discussed in many other studies. Patients with N2 disease tended to have a worse prognosis and, in some cases, preclude primary lung tumor surgery, [7,11,13,[26][27][28][29] as mediastinal lymph node involvement might suggest a heavier tumor burden that is not fit for surgery with curative intent.…”

Section: Prognostic Factors Associated With Prolonged Survivalmentioning

confidence: 99%

“…Hilar and mediastinal lymphadenectomy has been the standard part of surgical treatment for early and middle-stage NSCLC patients, and it should be taken into consideration during decision making for advanced stage patients with BM. [29] Several studies targeted this setting and got favorable results. Zhang [41] extracted stage IV NS-CLC cases from SEER database and grouped the cases according to whether lymph node dissection was performed.…”

Section: Retrospective Cohort Studymentioning

confidence: 99%

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Brain metastasis from non-small cell lung cancer: management and prognosis of primary lung tumor resection

Li,

Tong,

Sun

et al. 2023

Human Brain

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Brain metastases (BM) will develop in 30-50% of non-small cell lung cancer (NSCLC) patients in the course of their illness. Systemic treatment is recommended for most advanced-stage NSCLC patients with BM but the prognosis remains poor. The prognosis and management of primary lung tumor resection are still a debated topic in this complex clinical setting. The present study will gather and review related research evidence. The survival benefit, patient selection and proper surgical strategy of primary lung tumor resection will be summarized and discussed in the treatment for NSCLC patients with BM.

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Section: Prognostic Factors Associated With Prolonged Survivalmentioning

confidence: 99%

Section: Retrospective Cohort Studymentioning

confidence: 99%

Brain metastasis from non-small cell lung cancer: management and prognosis of primary lung tumor resection

Li,

Tong,

Sun

et al. 2023

Human Brain

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show abstract

“…Nonetheless, a handful of retrospective series on metastatic NSCLC patients with bone metastases unfortunately suggest poor outcomes for these patients with a 2-year survival of only 13% (58)(59)(60)(61). The discrepancy between these good local control rates and poor outcomes is presumably due to the limited amount of data available for this specific population, making treatment recommendations difficult (58)(59)(60)(61).…”

Section: Outcome Per Location: An Intricate Interplay Of Dose Volume and Primary Tumormentioning

confidence: 99%

Radiotherapy for oligometastatic non-small cell lung cancer: a narrative review

Sundahl

Lievens

2021

Transl Lung Cancer Res

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Preclinical and early clinical evidence suggest that radical radiotherapy of oligometastatic disease in non-small cell lung cancer (NSCLC) patients can impact outcomes with relatively limited toxicity. Whilst data from phase 2 randomized trials suggesting an improved overall survival (OS) with this treatment is promising, it has also illustrated the heterogeneity in this patient population and treatment.Oligometastatic disease in itself comprises a broad spectrum of patients, in terms of tumor load and location, stage of the disease and treatment history. This real-life variety in patient characteristics is often reflected in studies to a certain extent, hinting to the fact that all might benefit from radical radiotherapy to limited metastatic disease, yet leaving the question unanswered as to whom the ideal candidate is. Furthermore, differences between and within studies with regards to treatment modality, timing, radiation technique, and radiation dose are substantial. Also, preclinical and early clinical trials suggest that radiotherapy can work synergistically with checkpoint inhibitors by acting as an in situ cancer vaccine, therefore the combination of these two treatments in oligometastatic patients might entail the largest benefit. Ongoing randomized controlled phase 3 trials and prospective registry trials will further elucidate the true extent of benefit of this local treatment strategy and aid in identifying the ideal patient population and therapy. The current narrative review summarizes the clinical evidence on radiotherapy for oligometastatic NSCLC and highlights the remaining unknowns.

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Lung cancer in the emergency department

2023

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Background Though decreasing in incidence and mortality in the USA, lung cancer remains the deadliest of all cancers. For a significant number of patients, the emergency department (ED) provides the first pivotal step in lung cancer prevention, diagnosis, and management. As screening recommendations and treatments advance, ED providers must stay up-to-date with the latest lung cancer recommendations. The purpose of this review is to identify the many ways that emergency providers may intersect with the disease spectrum of lung cancer and provide an updated array of knowledge regarding detection, management, complications, and interdisciplinary care. Findings Lung cancer, encompassing 10–12% of cancer-related emergency department visits and a 66% admission rate, is the most fatal malignancy in both men and women. Most patients presenting to the ED have not seen a primary care provider or undergone screening. Ultimately, half of those with a new lung cancer diagnosis in the ED die within 1 year. Incidental findings on computed tomography are mostly benign, but emergency staff must be aware of the factors that make them high risk. Radiologic presentations range from asymptomatic nodules to diffuse metastatic lesions with predominately pulmonary symptoms, and some may present with extra-thoracic manifestations including neurologic. The short-term prognosis for ED lung cancer patients is worse than that of other malignancies. Screening offers new hope through earlier diagnosis but is underutilized which may be due to racial and socioeconomic disparities. New treatments provide optimism but lead to new complications, some long-term. Multidisciplinary care is essential, and emergency medicine is responsible for the disposition of patients to the appropriate specialists at inpatient and outpatient centers. Conclusion ED providers are intimately involved in all aspects of lung cancer care. Risk factor modification and referral for lung cancer screening are opportunities to further enhance patient care. In addition, with the advent of newer cancer therapies, ED providers must stay vigilant and up-to-date with all aspects of lung cancer including disparities, staging, symptoms of disease, prognosis, treatment, and therapy-related complications.

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How to handle oligometastatic disease in nonsmall cell lung cancer

Cited by 3 publications

References 111 publications

Brain metastasis from non-small cell lung cancer: management and prognosis of primary lung tumor resection

Brain metastasis from non-small cell lung cancer: management and prognosis of primary lung tumor resection

Radiotherapy for oligometastatic non-small cell lung cancer: a narrative review

Lung cancer in the emergency department

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