New horizons in non-small-cell lung cancer patients with ipsilateral pleural dissemination (M1a): review of the literature

Li, Hao; Liu, Taorui; Sun, Zewen; Wang, Zhenfan; Liu, Xianping; Yang, Fan

doi:10.21037/atm-20-6188

Cited by 8 publications

(6 citation statements)

References 53 publications

(70 reference statements)

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“…It is now virtually universally accepted that there are subsets of patients with stage IV NSCLC who benefit from curative intent therapy, with surgery being done very selectively ( 5 , 25 ). Studies suggested that PTR was associated with improved survival in patients with NSCLC with pleural carcinomatosis or extrathoracic metastatic, particularly for those with single-organ metastasis ( 7 , 11 , 14 , 17 , 19 , 20 ). Further studies identified the specific group with <60 years old, female, adenocarcinoma, well differentiation, tumor site in lobe, T1-2, N0, and M1a that were potentially associated with more favorable survival ( 7 , 26 ).…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Impact of Lymph Node Dissection on Primary Tumor Resection for Stage IV Non–Small Cell Lung Cancer: A Population-Based Study

Zhang

Cheng

et al. 2022

Front. Oncol.

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ObjectiveSelected patients with stage IV non–small cell lung cancer (NSCLC) who underwent primary tumor resection have witnessed a survival benefit. Whether additional lymph node dissection (LND) would result in a better effect remain unknown. We investigated the prognostic impact of LND on patients with stage IV NSCLC who received primary tumor resection (PTR).MethodsPatients with stage IV NSCLC who underwent PTR were identified from the Surveillance, Epidemiology, and End Results database from 2004 to 2016. Propensity-score matching was performed to minimize the confounding effect, and lung cancer-specific survival (CSS) and overall survival (OS) were compared after matching. Multivariable Cox regression was used to identify prognostic factors and to adjust for covariates in subgroup analysis. The effect of the number of lymph nodes examined on the CSS was evaluated by repeating the Cox analysis in a binary method.ResultsA total of 4,114 patients with stage IV NSCLC who receive surgery met our criteria, of which 2,622 (63.73%) underwent LND and 628 patients were identified 1:1 in LND and non-LND groups after matching. Compared with the non-LND group, the LND group had a longer CSS (median: 23 vs. 16 months, p < 0.001) and OS (median: 21 vs. 15 months, p < 0.001). Multivariable regression showed that LND was independently associated with favorable CCS [hazard ratio (HR) = 0.78, 95% confidence interval (CI) 0.69–0.89, P < 0.001] and OS (HR = 0.79, 95% CI 0.70–0.89, P < 0.001). Subgroup analysis suggested that LND is an independent favorable predictor to survival in the surgical patients who were older age (>60 years old), female, T3-4, N0, and M1a stage and those who underwent sublobar resection. In addition, a statistically significant CCS benefit was associated with an increasing number of lymph nodes examined through 25 lymph nodes.ConclusionsLND with a certain range of lymph nodes number examined was associated with improved survival for patients with stage IV NSCLC who received primary tumor resection. The results may have implications for guidelines on lymph nodes management in selective advanced NSCLC for surgery.

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Section: Discussionmentioning

confidence: 99%

The Prognostic Impact of Lymph Node Dissection on Primary Tumor Resection for Stage IV Non–Small Cell Lung Cancer: A Population-Based Study

Zhang

Cheng

et al. 2022

Front. Oncol.

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“…Not only distant metastatic lesions, but other factors such as concurrent intrathoracic metastatic lesion should also be considered. Recent studies show diverse clinical approaches in advanced NSCLC such as primary tumor resection, hyperthermic intrathoracic chemotherapy in patients with malignant pleural effusion, [50][51][52] and future studies that take various host and tumor-related factors into account are vital.…”

Section: Discussionmentioning

confidence: 99%

Association between clinical outcomes and local treatment in stage IV non‐small cell lung cancer patients with single extrathoracic metastasis

et al. 2022

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Background: Local treatment (LT) such as radiotherapy and metastasectomy on metastatic sites may improve outcomes in oligometastatic NSCLC patients, but more data are necessary to support LT in oligometastatic diseases. Patients with single extrathoracic metastatic lesion are more likely to benefit from local therapy. In this study, we evaluated the impact of LT in NSCLC patients with a single extrathoracic metastatic lesion. Methods: Data were obtained from the Korean Association for Lung Cancer Registry (KALC-R), a database created using a retrospective sampling survey by the Korean Central Cancer Registry (KCCR) and the Lung Cancer Registration Committee. Results: A total of 787 NSCLC patients with a single extrathoracic metastatic lesion were evaluated. In the multivariate analysis for OS, age, female sex, poor performance score, squamous histological subtype, LT, and initial treatment modality showed significant associations. Regarding LT, groups that underwent curative LT were significantly associated with better OS compared to groups that did not undergo LT (p = 0.011, HR 0.448, 95% CI: 0.242-0.829). In the multivariate analysis of patients who underwent LT, poor performance score, initial treatment modality, and T stage were independently associated with poor OS. Compared to the T1 stage, T3 stage showed an HR of 2.470 (95% CI: 1.309-4.663; p = 0.005) and T4 stage showed an HR of 2.063 (95% CI: 1.093-3.904; p = 0.026). Conclusion:In NSCLC with a single extrathoracic metastatic lesion, LT, especially for curative purposes, has an independent association with OS. Moreover, among the patients who received LT, factors such as T stage, poor performance score, and initial treatment modality were significantly associated with OS.

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“… 18 Additionally, several studies reported the effectiveness of hyperthermic intrathoracic chemotherapy (HITHOC) that it can control the symptoms and prolong the survival of patients with MPE. 34 Surgery combined with HITHOC has been recently reported to be an effective surgical intervention for selected pM1a patients to prolong life expectancy. A systematic review reported by Migliore et al 35 showed favorable outcomes for N0–1 NSCLC patients with MPE undergoing primary tumor resection plus HITHOC with a median survival time of 18 months and 2-year overall survival of 28.5%.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Treatment-Free Survival After Multimodal Therapy in a Patient with Stage IV Lung Adenocarcinoma

Takaoka¹,

Terai²,

Emoto³

et al. 2022

OTT

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We report the first case of a patient with non-small cell lung cancer (NSCLC) with malignant pleural effusion (MPE) who achieved disease- and treatment-free survival for nearly 10 years. A 50-year-old man was diagnosed with NSCLC with MPE and underwent chemotherapy and salvage thoracic surgery. The patient received chemotherapy with cisplatin, pemetrexed, and bevacizumab, and a partial response was achieved. After informed consent was obtained from the patient, right middle lobectomy was performed to achieve local tumor control. Postoperative adjuvant chemotherapy with pemetrexed and bevacizumab was discontinued after almost 1 year of chemotherapy due to side effects such as diarrhea and muscle weakness. The patient has survived without recurrence of lung cancer for more than 11 years after being diagnosed and nearly 10 years after discontinuing chemotherapy.

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New horizons in non-small-cell lung cancer patients with ipsilateral pleural dissemination (M1a): review of the literature

Cited by 8 publications

References 53 publications

The Prognostic Impact of Lymph Node Dissection on Primary Tumor Resection for Stage IV Non–Small Cell Lung Cancer: A Population-Based Study

The Prognostic Impact of Lymph Node Dissection on Primary Tumor Resection for Stage IV Non–Small Cell Lung Cancer: A Population-Based Study

Association between clinical outcomes and local treatment in stage IV non‐small cell lung cancer patients with single extrathoracic metastasis

Long-Term Treatment-Free Survival After Multimodal Therapy in a Patient with Stage IV Lung Adenocarcinoma

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