Chiaki Endo1, Tohru Hasumi2, Yuji Matsumura3, Nobuyuki Sato4, Hiroyuki Deguchi5, Hiroyuki Oizumi6, Motoyasu Sagawa7, Takao Tsushima8, Satomi Takahashi9, Jotaro Shibuya10, Masahide Hirose11, Takashi Kondo12. 1. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan. Electronic address: endo@idac.tohoku.ac.jp. 2. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Sendai Medical Center, Sendai, Japan. 3. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Ohta Nishinouchi Hospital, Kohriyama, Japan. 4. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan. 5. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Iwate Medical University Hospital, Morioka, Japan. 6. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Second Department of Surgery, Yamagata University Hospital, Yamagata, Japan. 7. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Kanazawa Medical University Hospital, Kahoku, Japan. 8. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic and Cardiovascular Surgery, Hirosaki University Hospital, Hirosaki, Japan. 9. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Miyagi Cancer Center, Natori, Japan. 10. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Iwate Prefectural Isawa Hospital, Ohshuu, Japan. 11. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Shizuoka General Hospital, Shizuoka, Japan. 12. Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.
Abstract
BACKGROUND: Purely localized, oligometastatic, and widely metastatic tumors are likely to require different therapeutic strategies. Although surgical procedures for isolated pulmonary, brain, or adrenal metastases from lung cancer have been extensively evaluated, most data are from retrospective studies; accordingly, we conducted a prospective multicenter trial. METHODS: Patients were eligible if they had previously untreated clinical T1-2N0-1 lung cancer with single-organ metastasis, or single-organ metachronous metastasis after complete resection of pathologic T1-2N0-1 lung cancer. Metastatic lesions were classified into three groups: group A included metastasis in single organs other than brain or lung; group B included synchronous brain metastasis; and group C included pulmonary metastasis. The treatment intervention was surgical resection of metachronous metastasis or of both synchronous metastasis and primary lung cancer. RESULTS: From December 2002 through June 2011, 36 patients were enrolled. Two patients were ineligible, and the remaining 34 were analyzed; 6 (18%) had a benign lesion and no metastasis, 5 patients (15%) underwent incomplete resection of primary lung cancer, and 20 patients (59%) underwent complete resection of both primary lung cancer and metastasis. The 5-year survival rate for these 20 cases was 44.7%. CONCLUSIONS: Clinical T1-2N0-1 lung cancer with a single-organ metastatic lesion was a good candidate for surgical resection. A 5-year survival rate of about 40% can be expected, which could be comparable with that for stage II non-small cell lung cancer.
BACKGROUND: Purely localized, oligometastatic, and widely metastatic tumors are likely to require different therapeutic strategies. Although surgical procedures for isolated pulmonary, brain, or adrenal metastases from lung cancer have been extensively evaluated, most data are from retrospective studies; accordingly, we conducted a prospective multicenter trial. METHODS:Patients were eligible if they had previously untreated clinical T1-2N0-1 lung cancer with single-organ metastasis, or single-organ metachronous metastasis after complete resection of pathologic T1-2N0-1 lung cancer. Metastatic lesions were classified into three groups: group A included metastasis in single organs other than brain or lung; group B included synchronous brain metastasis; and group C included pulmonary metastasis. The treatment intervention was surgical resection of metachronous metastasis or of both synchronous metastasis and primary lung cancer. RESULTS: From December 2002 through June 2011, 36 patients were enrolled. Two patients were ineligible, and the remaining 34 were analyzed; 6 (18%) had a benign lesion and no metastasis, 5 patients (15%) underwent incomplete resection of primary lung cancer, and 20 patients (59%) underwent complete resection of both primary lung cancer and metastasis. The 5-year survival rate for these 20 cases was 44.7%. CONCLUSIONS: Clinical T1-2N0-1 lung cancer with a single-organ metastatic lesion was a good candidate for surgical resection. A 5-year survival rate of about 40% can be expected, which could be comparable with that for stage II non-small cell lung cancer.
Authors: Elizabeth A David; James M Clark; David T Cooke; Joy Melnikow; Karen Kelly; Robert J Canter Journal: J Thorac Oncol Date: 2017-08-24 Impact factor: 15.609
Authors: Elizabeth A David; Robert J Canter; Yingjia Chen; David T Cooke; Rosemary D Cress Journal: Ann Thorac Surg Date: 2016-06-09 Impact factor: 4.330