BACKGROUND: The prognostic factors of oligometastatic non-small cell lung cancer (NSCLC) are uncertain. We performed a meta-analysis to assess the prognostic factors of oligometastatic NSCLC patients who are most likely to achieve long-term survival. METHODS: We searched PubMed, EMBASE, the Cochrane to identify eligible articles and performed the meta-analysis of all randomized controlled trials (RCTs) and retrospective comparative studies revealing the prognostic factors of oligometastatic NSCLC. The primary endpoint of interest was overall survival (OS). RESULTS: We analyzed data from twenty-four eligible studies, including data from 1,935 patients with oligometastatic NSCLC. In the univariate analysis, we found no significant difference in OS of prognostic factors including age [hazard ratios (HRs) 1.02, 95% CI: 0.80-1.31, P=0.86], smoking status (HR 1.08, 95% CI: 0.80-1.46, P=0.62), type of metastases (HR 1.61, 95% CI: 0.86-3.03, P=0.14), but significantly positive prognoses containing female (HR 1.21, 95% CI: 1.02-1.45, P=0.03), (y)pN0 stage (HR 1.82, 95% CI: 1.40-2.36, P<0.00001), adenocarcinoma (HR 1.44, 95% CI: 1.10-1.88, P=0.008). In the multivariate analysis, patients with (y)pN0 stage had an obvious survival benefit compared with (y)pN1 (HR 1.63, 95% CI: 1.27-2.10, P=0.001), but no significant survival in contrast with (y)pN2 (HR 2.01, 95% CI: 0.80-5.03, P=0.14). In subgroup analyses, neither thoracic stage (HR 2.06, 95% CI: 1.52-2.78, P=0.55), (y)pT-stage of primary lung cancer (HR 1.38, 95% CI: 0.86-2.21, P=0.14) nor tumorous histology (HR 2.99, 95% CI: 2.10-4.28, P=0.91) and oligometastatic number (HR 1.25, 95% CI: 0.97-1.62, P=0.98) were significantly different in OS. However, patients with aggressive thoracic treatment (ATT) had improved survival (HR 0.56, 95% CI: 0.37-0.83, P=0.001), and notably, different strategies of ATT received by oligometastatic NSCLC patients might significantly influence survival (HR 0.54, 95% CI: 0.36-0.82, P<0.00001). CONCLUSIONS: Overall, factors including age, smoking status, type of metastasis were not associated with long-term survival of oligometastatic NSCLC patients. However, our finding suggests that aggressive therapies in the primary lung cancer, as well as female, (y)pT-stage, absence of nodal diseases, adenocarcinoma histology have been clarified as positive prognosis. Further studies of prospective study for these patients are warranted.
BACKGROUND: The prognostic factors of oligometastatic non-small cell lung cancer (NSCLC) are uncertain. We performed a meta-analysis to assess the prognostic factors of oligometastatic NSCLC patients who are most likely to achieve long-term survival. METHODS: We searched PubMed, EMBASE, the Cochrane to identify eligible articles and performed the meta-analysis of all randomized controlled trials (RCTs) and retrospective comparative studies revealing the prognostic factors of oligometastatic NSCLC. The primary endpoint of interest was overall survival (OS). RESULTS: We analyzed data from twenty-four eligible studies, including data from 1,935 patients with oligometastatic NSCLC. In the univariate analysis, we found no significant difference in OS of prognostic factors including age [hazard ratios (HRs) 1.02, 95% CI: 0.80-1.31, P=0.86], smoking status (HR 1.08, 95% CI: 0.80-1.46, P=0.62), type of metastases (HR 1.61, 95% CI: 0.86-3.03, P=0.14), but significantly positive prognoses containing female (HR 1.21, 95% CI: 1.02-1.45, P=0.03), (y)pN0 stage (HR 1.82, 95% CI: 1.40-2.36, P<0.00001), adenocarcinoma (HR 1.44, 95% CI: 1.10-1.88, P=0.008). In the multivariate analysis, patients with (y)pN0 stage had an obvious survival benefit compared with (y)pN1 (HR 1.63, 95% CI: 1.27-2.10, P=0.001), but no significant survival in contrast with (y)pN2 (HR 2.01, 95% CI: 0.80-5.03, P=0.14). In subgroup analyses, neither thoracic stage (HR 2.06, 95% CI: 1.52-2.78, P=0.55), (y)pT-stage of primary lung cancer (HR 1.38, 95% CI: 0.86-2.21, P=0.14) nor tumorous histology (HR 2.99, 95% CI: 2.10-4.28, P=0.91) and oligometastatic number (HR 1.25, 95% CI: 0.97-1.62, P=0.98) were significantly different in OS. However, patients with aggressive thoracic treatment (ATT) had improved survival (HR 0.56, 95% CI: 0.37-0.83, P=0.001), and notably, different strategies of ATT received by oligometastatic NSCLC patients might significantly influence survival (HR 0.54, 95% CI: 0.36-0.82, P<0.00001). CONCLUSIONS: Overall, factors including age, smoking status, type of metastasis were not associated with long-term survival of oligometastatic NSCLC patients. However, our finding suggests that aggressive therapies in the primary lung cancer, as well as female, (y)pT-stage, absence of nodal diseases, adenocarcinoma histology have been clarified as positive prognosis. Further studies of prospective study for these patients are warranted.
Entities:
Keywords:
Prognostic factor; meta-analysis; non-small cell lung cancer (NSCLC); oligometastasis
Authors: Chaosu Hu; Eric L Chang; Samuel J Hassenbusch; Pamela K Allen; Shiao Y Woo; Anita Mahajan; Ritsuko Komaki; Zhongxing Liao Journal: Cancer Date: 2006-05-01 Impact factor: 6.860
Authors: Michael D Hasselle; Daniel J Haraf; Kyle E Rusthoven; Daniel W Golden; Ravi Salgia; Victoria M Villaflor; Niket Shah; Philip C Hoffman; Steven J Chmura; Philip P Connell; Everett E Vokes; Ralph R Weichselbaum; Joseph K Salama Journal: J Thorac Oncol Date: 2012-02 Impact factor: 15.609
Authors: Todd W Flannery; Mohan Suntharalingam; William F Regine; Lawrence S Chin; Mark J Krasna; Michael K Shehata; Martin J Edelman; Marnie Kremer; Roy A Patchell; Young Kwok Journal: Int J Radiat Oncol Biol Phys Date: 2008-02-14 Impact factor: 7.038
Authors: Robert J Downey; Kenneth K Ng; Mark G Kris; Manjit S Bains; Vincent A Miller; Robert Heelan; Mark Bilsky; Robert Ginsberg; Valerie W Rusch Journal: Lung Cancer Date: 2002-11 Impact factor: 5.705
Authors: Rafael A S Fernandez; Rainbow W H Lau; Jacky Y K Ho; Peter S Y Yu; Simon C Y Chow; Innes Y P Wan; Calvin S H Ng Journal: J Thorac Dis Date: 2019-04 Impact factor: 2.895
Authors: Lawek Berzenji; Sophie Debaenst; Jeroen M H Hendriks; Suresh Krishan Yogeswaran; Patrick Lauwers; Paul E Van Schil Journal: Transl Lung Cancer Res Date: 2021-07
Authors: Alicia Román-Jobacho; María Hernández-Miguel; María Jesús García-Anaya; Jaime Gómez-Millán; J A Medina-Carmona; Ana Otero-Romero Journal: J Clin Transl Res Date: 2021-05-27
Authors: Goda G Kalinauskaite; Ingeborg I Tinhofer; Markus M Kufeld; Anne A Kluge; Arne A Grün; Volker V Budach; Carolin C Senger; Carmen C Stromberger Journal: BMC Cancer Date: 2020-05-11 Impact factor: 4.430
Authors: Felipe Couñago; Javier Luna; Luis Leonardo Guerrero; Blanca Vaquero; María Cecilia Guillén-Sacoto; Teresa González-Merino; Begoña Taboada; Verónica Díaz; Belén Rubio-Viqueira; Ana Aurora Díaz-Gavela; Francisco José Marcos; Elia Del Cerro Journal: World J Clin Oncol Date: 2019-10-24
Authors: Agustin Buero; Walter S Nardi; Domingo J Chimondeguy; Leonardo G Pankl; Gustavo A Lyons; David Gonzalez Arboit; Sergio D Quildrian Journal: Ecancermedicalscience Date: 2021-11-25