Oligometastatic non-small cell lung cancer: is there a role for locoregional therapy?

Berzenji, Lawek; Schil, Paul Van

doi:10.21037/jtd.2017.06.108

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…According to our results, OM patients who were radically treated had a more robust OS and a significant prognostic difference depending on the metastatic site (i.e., a favourable factor in brain lesions) and the timing of presentation (synchronous vs metachronous) (1,28). Besides, OM patients at diagnosis had a better OS than patients with oligorecurrence and/or oligoprogression during or after medical treatments (29). Then, positive prognostic factors for survival included single organ metastasis, the pN0 status, smoking cessation, age <60, and histologic grade of G1/G2.…”

Section: Discussionmentioning

confidence: 58%

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Clinical prognostic factors in surgically treated oligometastatic non-small cell lung cancer: a systematic review

Bertolaccini¹,

Casiraghi²,

Sedda³

et al. 2021

Transl Lung Cancer Res

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Background: Since the concept of oligometastatic (OM) disease was introduced in the oncological scenario of non-small cell lung cancer (NSCLC), these patients progressively became a new category of stage IV NSCLC in whom the multimodality approach, including surgery, may improve prognosis. This systematic review aimed to investigate the clinical prognostic factors in OM-NSCLC surgically treated with radical intent.Methods: This systematic review is reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Cochrane's Collaboration Tool was used to determine the risk of bias for the included studies' primary outcome. A search strategy using a combination of freetext words, relevant MeSH headings and appropriate restrictions (time limit: from January 1997 to March 2020, language: English) was designed. Potentially qualified papers were subjected to an in-depth fulltext examination after preliminary title/abstract screening to identify studies for inclusion in the systematic review. Data extracted included: study characteristics, baseline patient characteristics, primary and secondary outcomes. The Cochrane's Collaboration Tool was used to determine the risk of bias for included studies' primary outcome. The risk of bias due to incomplete outcome data was evaluated at an outcome level.However, at the study stage, the possibility of bias due to sequence generation, allocation concealment, blinding, selective reporting, or funding was assessed. Two independent observers calculated the probability of bias, and differences were resolved through dialogue and consensus.Results: Nine studies were selected. Overall survival (OS) was 51.8 months and varied from 21.1 to 60 months, but results were not statistically significant. Positive prognostic factors for survival were cessation of smoking, age <60, a histologic grade of G1/G2, pN0. The presence of extra-brain OM and multiple metastases negatively affected survival.Discussion: For otherwise stable patients with a single organ site with synchronous (or metachronous) extrathoracic M1 disease and no intrathoracic lymph node involvement, aggressive treatment should be used in the absence of randomized evidence to help determine the effective management of OM-NSCLC.

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Section: Discussionmentioning

confidence: 58%

“…Suppose we considered that a possible disease progression is usually more likely to occur at the DM sites at diagnosis rather than in new sites. In that case, patients with OM-NSCLC could benefit in terms of survival from the local treatment of the metastasis, such as surgery or radiotherapy (29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

Clinical prognostic factors in surgically treated oligometastatic non-small cell lung cancer: a systematic review

Bertolaccini¹,

Casiraghi²,

Sedda³

et al. 2021

Transl Lung Cancer Res

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“…The oligometastatic disease is an anew category of patients where multimodality therapy may improve prognosis. Many intriguing enquiries about the oligometastatic disease have no definite answer now (17). Without randomised data to better define the appropriate management of oligometastatic NSCLC, an aggressive therapy for fit patients with a single organ site of synchronous (or metachronous) extrathoracic M1 disease and without intrathoracic lymph nodes involvement should be used.…”

Section: Discussionmentioning

confidence: 99%

Surgical approaches in patients with oligometastatic non-small cell lung cancer

Bertolaccini¹,

Pardolesi²,

Parri³

et al. 2018

J. Thorac. Dis.

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In recent years, retrospective analyses have suggested that an oligometastatic state could exist, but the best evidence to date that a temporary oligometastatic disease exists for lung cancer mainly derives from the survival data on retrospective patients underwent surgical resection of a single M1 site and all intrathoracic disease. The critical determinates of long-term survival include definitive treatment of the primary non-small cell lung cancer (NSCLC), a single organ site of synchronous or metachronous disease, a long disease-free interval between treatment of the primary NSCLC and development of metastases, and the absence of intrathoracic lymph node (N0) disease. The ongoing development of innovative approaches to local therapy and treatment directed to the oligometastatic sites should be defined in future studies.

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