Prognostic differences between oligometastatic and polymetastatic extensive disease-small cell lung cancer

Abstract

Purpose Oligometastasis is a state in which cancer patients have a limited number of metastatic tumors; patients with oligometastases survive longer than those with polymetastases. Extensive disease (ED)-small cell lung cancer (SCLC) is considered a systemic disease and a poor survival. This study investigated whether the concept of oligometastases is prognostic factor also applicable to patients with ED-SCLC. Methods We performed a retrospective study of 141 consecutive patients with ED-SCLC between 2008 and 2016. The patients were divided into four subgroups: group 1; patients with solitary metastatic site in one organ (n = 31), group 2; patients with 2–5 metastatic sites in one organ (n = 18), group 3; patients with over 6 metastases in one organ (n = 15), and group 4; patients with 2 or more metastatic organs (n = 77). Results It was identified that 49 patients with ED-SCLC had oligometastases (groups 1 + 2) and 92 had polymetastases (groups 3 + 4). The prognoses of patients with ED-SCLC and oligometastases, defined as ≤5 metastases in a single organ, were significantly superior to those of patients with polymetastases [16.0 (95% CI, 11.0–21.0) months vs. 6.9 (95% CI, 6.0–7.8) months; p<0.001]. 43 of 49 patients with ED-SCLC and oligometastases were relapsed after initial chemotherapy, and 38 (88%) experienced local recurrence. Conclusions Patients with ED-SCLC and oligometastases may have improved survival than those with polymetastases. As oligometastatic ED-SCLC tends to recur locally, local therapy combined with systemic chemotherapy may be a treatment option.

Small cell lung cancer with thyroid gland oligometastasis: A case report

“…Shirasawa et al . also reported prognostic differences between oligometastatic and polymetastatic ED‐SCLC 9 . A total of 49 of the 141 patients in this study were reported to have oligometastatic ED‐SCLC.…”

“…Shirasawa et al . reported a better prognosis for oligometastatic ED‐SCLC than polymetastatic disease 9 . Furthermore, the study suggested that local brain irradiation may benefit patients with oligometastatic ED‐SCLC.…”

The Clinical Features and Treatment Responses of Small Cell Lung Cancer Patients: A Single- Center Experience

“…This is related to decreased survival (7). However, as in limited-stage disease, it is reported that better treatment responses and survival can be achieved when detected as oligometastatic disease, even if it is an extensive- stage disease (8). Nevertheless, as in the literature, the majority of our patients consisted of extensivestage and poly-metastatic patients.…”

Diagnosis and referral of adults with suspected bony metastases

“…Early identification and surgical treatment of low volume “oligometastatic” metastatic disease (<5 discrete lesions throughout body within a single “organ”—eg, purely bony metastases)124445…”