Yoshihisa Shimada1, Hisashi Saji2, Masatoshi Kakihana3, Naohiro Kajiwara3, Tatsuo Ohira3, Norihiko Ikeda3. 1. Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan zenkyu@za3.so-net.ne.jp. 2. Department of Chest Surgery, St. Marianna University School of Medicine, Tokyo, Japan. 3. Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
Abstract
BACKGROUND: We investigated the factors associated with post-recurrence survival and the treatment for non-small-cell lung cancer patients with postoperative distant recurrence, especially oligometastasis. METHODS: We reviewed the data of 272 patients with distant recurrence who underwent resection of non-small-cell lung cancer from January 2000 through December 2011. RESULTS: The type of distant recurrence was classified as oligometastasis (n = 76, 28%) or polymetastasis (n = 196, 72%). Forty-seven (62%) patients with oligometastasis received local therapy (surgery 5, radiotherapy 9, sequential local and systemic therapy 28, chemoradiotherapy 5). Multivariate analysis revealed older age, non-adenocarcinoma, shorter disease-free interval, no pulmonary metastasis, liver metastases, bone metastases, and polymetastasis had significant associations with unfavorable post-recurrence survival. Subgroup analysis of patients with oligometastasis showed histology and disease-free interval had a great impact on survival. Smoking history and histology were associated with survival in patients with lung oligometastasis, whereas systemic treatment and longer disease-free interval were related to increased post-recurrence survival in those with brain oligometastasis. CONCLUSIONS: This study showed that an oligometastatic state per se was a significant favorable factor. Optimization of personalized systemic treatment and adding local treatment are important in the management of patients with non-small-cell lung cancer and oligometastasis.
BACKGROUND: We investigated the factors associated with post-recurrence survival and the treatment for non-small-cell lung cancerpatients with postoperative distant recurrence, especially oligometastasis. METHODS: We reviewed the data of 272 patients with distant recurrence who underwent resection of non-small-cell lung cancer from January 2000 through December 2011. RESULTS: The type of distant recurrence was classified as oligometastasis (n = 76, 28%) or polymetastasis (n = 196, 72%). Forty-seven (62%) patients with oligometastasis received local therapy (surgery 5, radiotherapy 9, sequential local and systemic therapy 28, chemoradiotherapy 5). Multivariate analysis revealed older age, non-adenocarcinoma, shorter disease-free interval, no pulmonary metastasis, liver metastases, bone metastases, and polymetastasis had significant associations with unfavorable post-recurrence survival. Subgroup analysis of patients with oligometastasis showed histology and disease-free interval had a great impact on survival. Smoking history and histology were associated with survival in patients with lung oligometastasis, whereas systemic treatment and longer disease-free interval were related to increased post-recurrence survival in those with brain oligometastasis. CONCLUSIONS: This study showed that an oligometastatic state per se was a significant favorable factor. Optimization of personalized systemic treatment and adding local treatment are important in the management of patients with non-small-cell lung cancer and oligometastasis.
Authors: Johannes Schwenck; Hansjoerg Rempp; Gerald Reischl; Stephan Kruck; Arnulf Stenzl; Konstantin Nikolaou; Christina Pfannenberg; Christian la Fougère Journal: Eur J Nucl Med Mol Imaging Date: 2016-08-24 Impact factor: 9.236
Authors: Till Plönes; Walburga Engel-Riedel; Erich Stoelben; Christina Limmroth; Oliver Schildgen; Verena Schildgen Journal: J Pers Med Date: 2016-01-15