Prognostic impact of M descriptors of the 8th edition of TNM classification of lung cancer

Dias, Margarida; Antunes, Ana; Campainha, Sérgio; Conde, Sara; Barroso, Ana

doi:10.21037/jtd.2017.03.106

Cited by 17 publications

(10 citation statements)

References 14 publications

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“…Among patients' demographic data, squamous cell histology was more common in patients with M1b disease than in those with M1a or M1c disease. Similar observation was also noted in the prior small cohort study of 172 patients with stage IV disease, in which 30 patients (17%) had M1b disease and 29% had squamous cell carcinoma [11]. Although the exact biological mechanisms remain to be clarified, the observations are consistent with the prior knowledge that squamous cell carcinoma of the lung tends to be locally aggressive and less frequently develop metastasis to distant organs compared with adenocarcinoma [16,17].…”

Section: Discussionsupporting

confidence: 89%

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M1b Disease in the 8th Edition of TNM Staging of Lung Cancer: Pattern of Single Extrathoracic Metastasis and Clinical Outcome

et al. 2019

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Background The 8th edition of TNM staging of non‐small cell lung cancer (NSCLC) has revised M classification and defined M1b disease with single extrathoracic metastasis, which is distinguished from M1c with multiple extrathoracic metastases. We investigated the prevalence, characteristics, and overall survival (OS) of M1b disease in patients with stage IV NSCLC. Methods The study reviewed the medical records and imaging studies of 567 patients with stage IV NSCLC to determine M stage using the 8th edition of TNM staging. Clinical characteristics and OS were compared according to M stages. Results Among 567 patients, 57 patients (10%) had M1b disease, whereas 119 patients (21%) had M1a disease and 391 patients (69%) had M1c disease. Squamous histology was more common in M1b (16%) than in M1a (6%) and M1c (6%; p = .03). The median OS of patients with M1b disease was 14.8 months, compared with 22.6 months for patients with M1a and 13.4 months for those with M1c disease (p < .0001). Significant OS differences of M1b compared with single‐organ M1c and multiorgan M1c groups were noted (single‐organ M1c vs. M1b: hazard ratio [HR], 1.49; p = .02; multiorgan M1c vs. M1b: HR, 1.57; p = .01) in multivariable analyses adjusting for smoking and systemic therapy types. Among patients with M1b disease, the brain was the most common site of single metastasis (28/57; 49%), followed by bone (16/57; 28%). Single brain metastasis was more frequently treated with local treatment (p < .0001). Conclusion M1b disease was noted in 10% of patients with stage IV NSCLC. Squamous histology was more common in M1b group than others. The brain was the most common site of single metastasis and was often treated locally. Implications for Practice The newly defined group of M stage consists of a unique subset among patients with stage IV non‐small cell lung cancer that can be studied further to optimize treatment approaches.

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Section: Discussionsupporting

confidence: 89%

“…In the present study, M1b disease consisted of 10% of the stage IV NSCLC cohort. A few studies have reported the prevalence of M1b disease in stage IV NSCLC using the 8th edition, ranging from 9.7% to 17% . The observation in the present study falls into this range and confirms that M1b disease is relatively uncommon among stage IV NSCLC.…”

Section: Discussionsupporting

confidence: 82%

M1b Disease in the 8th Edition of TNM Staging of Lung Cancer: Pattern of Single Extrathoracic Metastasis and Clinical Outcome

et al. 2019

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“…OMD and OPD are not well-established as disease concepts for breast cancer patients, in contrast to other tumor entities. On the contrary, the recent 8th edition of the TNM classification of lung cancer describes a M-subgroup for patients with OMD (16). There is no such subclassification in breast cancer patients with OMD (17).…”

Section: Background and Purposementioning

confidence: 99%

Extracranial Stereotactic Body Radiotherapy in Oligometastatic or Oligoprogressive Breast Cancer

et al. 2020

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Purpose/Objective: Oligometastatic disease (OMD) and oligoprogressive disease (OPD) describe tumor states with a limited metastasization. In contrast to other disease states, treatment of OMD or OPD has not yet become common for breast cancer. We sought to understand the outcomes and toxicities of this treatment paradigm. Material/Methods: We retrospectively analyzed female breast cancer patients with OMD (≤3 metastases) or OPD (1 progressive lesion) who received stereotactic body radiotherapy (SBRT) for their respective extracranial metastatic lesions between 01/2002 and 07/2019. Survival analysis was performed using the Kaplan-Meier method with log-rank test being used for evaluation of significance. Cox regression was used to detect prognostic outcome factors. Toxicity was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE v. 5.0). Results: Forty-six patients (70% OMD; 30% OPD) with 58 lesions met criteria for inclusion. The majority of treatments (34 out of 58; 58.6%) were delivered from 2017 to 2018. Treatment sites were bone, liver, lung [n = 19 (33%) for each site], and adrenal gland [n = 1 (1%)]. Median biologically effective dose (BED at α/β = 10) was 81.6 Gy (range: 45-112.5 Gy) and median planning target volume was 36.60 mL (range: 3.76-311.00 mL). At 2 years, local control (LC) was 89%, distant control (DC) was 44%, progression free survival (PFS) was 17% and overall survival (OS) was 62%. Multivariate analysis identified the diagnosis of a solitary metastasis as an independent prognostic factor for superior DC (HR = 0.186, CI [0.055; 0.626], p = 0.007) and PFS (HR = 0.363, CI [0.152; 0.863], p = 0.022). OS was independently inferior for patients treated at a higher age (HR = 5.788, CI [1.077; 31.119] p = 0.041). Nine (15.5%) grade I • and one (1.7%) grade II • toxicities were recorded, with no grade III • or higher toxicities. Weykamp et al. SBRT in Oligometastatic Breast Cancer Conclusion: Extracranial SBRT in breast cancer patients with OMD or OPD was well-tolerated with excellent LC. SBRT should especially be offered to younger OMD and OPD breast cancer patients with only one metastasis. The increase in utilization since 2017 points toward a growing acceptance of SBRT for OMD and OPD in breast cancer.

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“…The number of metastasis organs in advanced lung cancer is an important factor for survival and prognosis of patients, the more metastasis organs, the worse prognosis [28][29] . Patients with liver metastases are associated with poor outcomes and the worst prognosis (median PFS 1.15 vs 3.24months, median OS 3-4 vs 5-8months) than non-liver metastases in the advanced NSCLC [30][31][32] .…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of ECOG PS and adverse reactions in patients with anlotinib at advanced NSCLC as the third or further line treatment: a retrospective observational study

Deng

et al. 2020

Preprint

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Background: Previous studies have shown that anlotinib be a decent choice in third- or futher line treatment of advanced NSCLC. However, the study anslysis of relationship between Eastern Cooperative Oncology Group performance status(ECOG PS) and adverse reactions in advanced NSCLC with anlotinib therapy is less. Methods: We evaluated the efficacy and toxicity of anlotinib in patients with previously treated advanced NSCLC from June 2018 to March 2019. Survival analysis was performed by the Kaplan–Meier method.Results: According to ECOG PS devided into PS 0-1 group(n=63) and PS 2 group(n=28) . The PS 0-1 of median progression-free survival (mPFS, 5.5 vs.2.7 months, P＜0.05) , overall survival (mOS, 9.2 vs.4.7 months，P＜0.05) was longer than PS 2. The PS 0-1 of objective remission rate(ORR, 45.1% vs 6.6%), disease control rate(DCR, 8.8% vs 1.1%) was significanly more than PS 2. The PS 0-1 group of I-II adverse reactions was high than PS 2 group(52.3% vs 32.1%), but the III-IV adverse reactions were less than PS 2 group(9.5% vs 10.7%). Moreover, multivariate analysis indicated that PS was independent risk factor of PFS（HR=2.816, 95%CI：1.661-4.773，P<0.0001）as well as OS(HR=3.188, 95%CI：1.789-5.682，P=0.0001) for anlotinib therapy in NSCLC. Conclusions: Patients in advanced NSCLC with PS 0–1 get better PFS and OS than PS 2 followed by anlotinib treatment in NSCLC. Advanced lung squamous cell carcinoma(LUSC) recived anlotinib treatment with the same efficacy comparable to adenocarcinoma, and patients with PS 0-1 may benefit the most than PS 2.

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Prognostic impact of M descriptors of the 8th edition of TNM classification of lung cancer

Cited by 17 publications

References 14 publications

M1b Disease in the 8th Edition of TNM Staging of Lung Cancer: Pattern of Single Extrathoracic Metastasis and Clinical Outcome

M1b Disease in the 8th Edition of TNM Staging of Lung Cancer: Pattern of Single Extrathoracic Metastasis and Clinical Outcome

Extracranial Stereotactic Body Radiotherapy in Oligometastatic or Oligoprogressive Breast Cancer

Clinical analysis of ECOG PS and adverse reactions in patients with anlotinib at advanced NSCLC as the third or further line treatment: a retrospective observational study

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