Objectives: A few studies have already demonstrated survival benefits for local treatment in solitary metastatic non-small-cell lung cancer (NSCLC). The aim of this study is to retrospectively investigate the role of surgery in patients with oligometastatic (OM) NSCLC. Methods: Between January 1998 and December 2018, 57 patients with OM stage IV NSCLC (1 or 2) underwent a multidisciplinary approach including lung cancer surgery, local treatment of the distant metastasis (DM) and systemic medical treatments. Results: All patients had DM synchronous to lung cancer. Fifty-one (90%) patients had a single DM whereas 6 (11%) patients had 2 DMs. Forty-eight (84%) patients underwent induction chemotherapy. We performed 47 (82%) lobectomies, 4 (7%) segmentectomies and 6 (11%) pneumonectomies. Pathological lymph node involvement was evident in 28 (49%) patients. Adjuvant chemotherapy was administered in 20 (35%) patients. Forty-six (81%) patients had local treatment of the DM before lung resection, and 11 (19%) patients had after lung resection; 6 (11%) patients had both treatments. The median overall survival (OS) was 30 months, with the 2-, 3- and 5-year OS of 57%, 50% and 30%, respectively. OS was significantly related to lymph node involvement (P = 0.04), size of the primary tumour (P < 0.001), neoadjuvant chemotherapy (P = 0.02) and the time period between metastasis diagnosis and primary tumour removal (P = 0.04). Conclusions: Multidisciplinary approach is the gold standard in OM patients. Patients with no lymph node involvement are the best candidates, with an acceptable OS. Thus, patients with OM-NSCLC should not be excluded from surgery as a matter of principle.
Lung cancer surgery in oligometastatic patients: outcome and survival / M. Casiraghi, L. Bertolaccini, G. Sedda, F. Petrella, D. Galetta, J. Guarize, P. Maisonneuve, F. De Marinis, L. Spaggiari. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 57:6(2020 Jun 01), pp. 1173-1180.
|Titolo:||Lung cancer surgery in oligometastatic patients: outcome and survival|
|Parole Chiave:||Non-small cell lung cancer; Oligometastasis; Surgery.|
|Settore Scientifico Disciplinare:||Settore MED/21 - Chirurgia Toracica|
|Data di pubblicazione:||1-giu-2020|
|Data ahead of print / Data di stampa:||15-gen-2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1093/ejcts/ezaa005|
|Appare nelle tipologie:||01 - Articolo su periodico|
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