Survival of patients treated surgically for synchronous single-organ metastatic NSCLC and advanced pathologic TN stage

Collaud, Stéphane; Stahel, Rolf A.; İnci, İlhan; Hillinger, Sven; Schneiter, Didier; Kestenholz, Peter; Weder, Walter

doi:10.1016/j.lungcan.2012.09.011

Cited by 74 publications

(59 citation statements)

References 18 publications

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“…Concerning with N-stage, Tamura et al (27), in a retrospective cohort study involving 761 stage IV NSCLC patients, reported N0 patients presented a significant increased survival when compared to N1-3 ones (11.9 vs. 7.2 months, P<0.001), thus suggesting lymph node metastases were independent prognostic factors. Similarly, tumor size seems to strongly influence prognosis, as reported by Collaud et al (28) in a small retrospective single-centre study. The authors, involving 29 surgically treated oligometastatic patients, showed a 1-and 5-year OS of 65% and 36%, respectively.…”

Section: Oligometastatic Disease: State Of Artsupporting

confidence: 58%

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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Section: Oligometastatic Disease: State Of Artsupporting

confidence: 58%

Surgical approach in the oligometastatic patient

Divisi¹,

Barone²,

Zaccagna³

et al. 2018

Ann. Transl. Med.

View full text Add to dashboard Cite

show abstract

“…37 In a study by Collaud et al, a similar trend is seen with tumor size, with T1–2 stage IV NSCLC patients who undergo resection having a median 5-year survival of 26 months compared to only 8 months in T3–4 patients (p=0.007). 38 Additionally, data suggest that the timing of metastatic disease development may affect survival, with metachronous oligometastatic stage IV NSCLC patients having improved survival as opposed to synchronous oligometastatic disease. 39,40 However, other studies have reported no difference in outcomes between metachronous and synchronous oligometastatic disease in NSCLC likely reflecting that these studies are underpowered for these analyses.…”

Section: Resultsmentioning

confidence: 99%

“…In fact, authors of these studies have reported long term survivors despite the diagnosis of metastatic NSCLC, and in some cases, 5-year survival following resection of oligometastatic disease has been reported as high as 50%. 15–20,38,41–43 (Table 1.) Some series have also suggested that for patients with early stage intrathoracic disease whose oligometastatic disease is managed with definitive intent local therapy with either radiation or surgical resection, survival can be similar to patients with Stage II disease.…”

Section: Resultsmentioning

confidence: 99%

The Role of Thoracic Surgery in the Therapeutic Management of Metastatic Non–Small Cell Lung Cancer

David

Clark

Cooke

et al. 2017

Journal of Thoracic Oncology

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Introduction The majority of non-small cell lung cancer (NSCLC) patients are diagnosed with advanced stage disease for whom the prognosis is poor and survival is typically measured in months. Standard therapeutic treatment regimens for patients with stage IV NSCLC typically include chemotherapy and palliative radiation. Despite newer regimens that may include molecularly targeted therapy and immunotherapy, the overall 5-year survival for stage IV disease remains low at 4–6%. Although therapeutic surgery is performed in a minority of cases, accumulating data suggest that thoracic surgery may play several beneficial roles for these patients. Methods In this narrative review, we summarize the literature on surgical intervention in the multimodality management of stage IV NSCLC; focusing on the potential evidence for and against therapeutic/curative intent procedures to impact outcomes for patients with oligometastatic disease and pleural metastasis. Results In selected patients, surgical resection can result in a 5-year survival of 30–50%, but this is heavily influenced by the presence of mediastinal nodal disease, which should be evaluated before therapeutic surgical procedures are undertaken. Additionally, diagnostic or palliative surgical procedures can play an important role in the personalized management of stage IV disease. These data suggest that for carefully selected patients with advanced stage NSCLC, surgical intervention can be an important component of combined modality treatment. Conclusions Given advances in molecular targeted therapy and immunotherapy, further studies should focus on the possible use of surgery as a strategy of therapeutic “consolidation” for appropriately selected patients with stage IV NSCLC receiving combined modality care.

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“…Another important idea is that survival benefit is also related to the extension of the primary tumor (4,13,14). The authors of this paper (13) identify the pT stage as a predictor of survival, being patients with the lower pT stage the ones having most favorable prognosis.…”

Section: The Role For a Proper Selection Of Patientsmentioning

confidence: 99%

“…As a group, the median survival time for patients with intrapulmonary metastastic disease is better (56 months; 95% CI, 37.2-74.8; P=0.001) than the expected one for patients with extrapulmonary metastasis (18 months; 95% CI, 8.5-27.5) (11). Metastasis seems to be more frequent at the ipsilateral lung (13). When synchronous single contralateral lesions are diagnosed, most patients undergo bilateral staged lobectomies achieving favorable long-term survival (5-year survival time: 45%).…”

Section: Lung Metastasismentioning

confidence: 99%