Abstract

OBJECTIVE
The role of surgery in the multimodal therapy for selected stage IV oligometastatic non-small cell lung cancer (NSCLC) is still a forum of open discussion.
METHODS
We have retrospectively analyzed the records of 53 patients with oligometastatic NSCLC who had been treated with curative intent in the period January 1997 to May 2010.
RESULTS
The mean age and the male/female ratio were 61 years and 32:21, respectively. A single metastatic lesion was present in 45 (84.9%) subjects, in 2 patients there were 2 different anatomic sites involved, and in 8 patients there were 2 metastases in the same site. The most common involved sites were brain (39), followed by adrenal gland (7), bone (3), vertebrae (3), liver (1), and contralateral supraclavicular lymph node (1). Distant disease was completely resected in 42 patients; 10 patients were treated with exclusive chemotherapy and/or radiotherapy and 1 with local laser therapy. Twenty-nine patients had been administered concurrent chemoradiation in a neoadjuvant setting before the surgical treatment at the lung or both sites (primary/distant). The pulmonary resection was complete (R0) in 42 patients (79.2%). Overall, 1- and 5-year survivals were 73.1% and 24%, respectively (median follow-up, 28 months). Median overall survival, local disease-free survival, and distant disease-free survival, estimated using the Kaplan-Meier method, were respectively 19, 72, and 12 months. After stepwise multivariate analysis, the weight loss (P<.001), the completeness of pulmonary resection (P=.0019), and, interestingly, the performance of a positron emission tomography-computed tomography scan in preoperative staging (P=.05) maintained their independent prognostic value as overall survival determinants.
CONCLUSIONS
Surgical treatment for selected stage IV NSCLC is feasible and safe. Furthermore, good survival can be expected in those patients in whom a complete resection of the primary tumor and radical control of the distant diseases are accomplished.

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Publisher Full Text

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Authors

Congedo MT, Cesario A, Lococo F, De Waure C, Apolone G, Meacci E, Cavuto S, Granone P

Institution

Department of General Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy. t.congedo@libero.it

Source

The Journal of thoracic and cardiovascular surgery 144:2 2012 Aug pg 444-52

MeSH

Adrenal Gland Neoplasms
Adult
Aged
Brain Neoplasms
Carcinoma, Non-Small-Cell Lung
Female
Humans
Kaplan-Meier Estimate
Lung Neoplasms
Male
Middle Aged
Prognosis
Treatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22713303