Radical treatment of synchronous oligometastatic non-small cell lung carcinoma (NSCLC): Patient outcomes and prognostic factors

Griffioen, Gwendolyn H.M.J.; Toguri, D.; Dahele, Max; Warner, Andrew; Haan, Patricia F. de; Rodrigues, George; Slotman, Ben J.; Yaremko, Brian; Senan, Suresh; Palma, David A.

doi:10.1016/j.lungcan.2013.07.023

Cited by 143 publications

(132 citation statements)

References 20 publications

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“…23,51 The relatively poor results of RT in comparison with surgery may also be attributed to differences in patient selection. 44 In the surgical literature, the majority of patients have metastases confined to the adrenal or have extra-adrenal OM which have also been aggressively treated; have usually had their primary disease resected; must be technically resectable; and medically operable.…”

Section: Discussionmentioning

confidence: 99%

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

Thomsen¹,

Fairchild²

2017

Oncology &Amp; Hematology Review (US)

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B ackground: Five-year overall survival (OS) for patients with stage IV non-small cell lung cancer (NSCLC) is a dismal 1%. However, approximately 7% have limited or solitary metastases, including to the adrenal gland. Radical treatment of these oligometastases (OM) could increase local control and improve OS. Our objective was to critically analyze data describing aggressive treatment of adrenal OM secondary to NSCLC. Methods: A literature search examining English publications describing surgery or radiotherapy (RT) was performed, supplemented by searching reference lists. Case reports of three or fewer patients, and articles from which NSCLC-or adrenal-specific clinical outcomes could not be abstracted, were excluded. Results: Twenty-nine studies met eligibility criteria (521 patients), 26 retrospective. No publications directly compare modalities. Four surgery studies described contemporaneous patients treated with palliative chemotherapy (CH) alone. Reported median OS ranged from 9.5-64 months after adrenalectomy, 8-23 months after RT, and 6-8.5 months after CH. Local failure after surgery was 14%, with response rates after RT 57-75%. Both appear well-tolerated. Conclusions: In patients with an adrenal OM secondary to NSCLC, aggressive treatment should be considered. However, due to the paucity of high quality evidence, it is unclear at present whether this approach alters the natural history of the disease.

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Section: Discussionmentioning

confidence: 99%

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

Thomsen¹,

Fairchild²

2017

Oncology &Amp; Hematology Review (US)

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“…Finally, when consider prognosis in stage IV disease, another significant aspect to consider is the site of metastases. In particular, brain or adrenal gland secondary lesion seem to be associated with prolonged survival rather than bone or liver ones (21,(29)(30)(31)(32)(33)(34)(35). Referring to the above risk factors, it is possible to stratify and identify patients who are candidates for aggressive local treatment.…”

Section: Oligometastatic Disease: State Of Artmentioning

confidence: 99%

Surgical approach in the oligometastatic patient

Divisi¹,

Barone²,

Zaccagna³

et al. 2018

Ann. Transl. Med.

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In the setting of a stage IV non-small cell lung cancer (NSCLC), oligometastatic patients represent a heterogeneous group whose incidence is increasing as far as with the adoption of new therapeutic regimens, the improvement of the molecular characterization assays and the increasing number of longsurvivor patients. The oligometastatic state undergone a major revision with the introduction of the new TNM lung cancer staging system, being characterized by a different prognosis compared to multimetastatic patients. Furthermore, the presence of a limited number of metastases imposes a local control especially when clonal selections occur during adjuvant therapy. In this regard, the review seeks to clarify the indications for surgical treatment by organ according to recent guidelines, by analyzing prognostic factors and outcome of patients. Although accurate patient stratification is mandatory, aggressive local control strategies represent a valid therapeutic approach in patients with oligometastatic NSCLC. At the same time, persevering with ablative strategies raises both medical and ethical issues about limits and reiteration, which certainly requires a deep reflection, being, on the other hand, in front of a metastatic disease.

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“…56 Other prognostic factors include definitive control of the primary tumor, and lower intrathoracic disease burden in patients undergoing thoracic radiotherapy. 56,58,59 5.5.…”

Section: Sbrt For Oligometastatic Nsclcmentioning

confidence: 99%

Radical treatment of synchronous oligometastatic non-small cell lung carcinoma (NSCLC): Patient outcomes and prognostic factors

Cited by 143 publications

References 20 publications

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

Surgical approach in the oligometastatic patient

Stereotactic radiotherapy for early lung cancer: Evidence-based approach and future directions

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