Skip to main content
Erschienen in: European Surgery 6/2016

01.12.2016 | Original Article

Surgical approach is superior to palliative treatment in oligometastatic lung cancer

verfasst von: Till Plönes, MD, Alberto Lopez-Pastorini, Erich Stoelben

Erschienen in: European Surgery | Ausgabe 6/2016

Einloggen, um Zugang zu erhalten

Summary

Background

The majority of patients with lung cancer are diagnosed in a metastatic state, in which prognosis is rather poor. Chemotherapy can improve median overall survival by only a few months, but a small percentage of these patients suffer only from oligometastatic diseases and may therefore be treated with curative intend. In this study, we compared two groups of patients with oligometastatic lung cancer, who received palliative treatment or multimodal treatment with a surgical approach.

Methods

We conducted a retrospective review of all patients with synchronous extrapulmonary oligometastatic disease diagnosed between 2010 and 2013. All data were extracted from the medical database of our department and further analysed.

Results

There were 52 patients diagnosed with oligometastatic lung cancer between 2010 and 2013. A cohort of 32 patients was treated surgically in a multimodal approach, but 19 patients refused surgery. These patients were treated by palliative chemotherapy or other palliative treatments, such as radiochemotherapy etc. Median overall survival was 18 months in the surgically treated group and 6 months in the palliative group (p < 0.001). In the surgically treated group, survival was correlated to pathologic T stage (pT1 29 months, pT2 13 months and pT3 13 months median overall survival, p < 0.05) and lymph node involvement (with mediastinal lymph node involvement 13 months and without mediastinal lymph node involvement 28 months median overall survival).

Conclusion

We conclude that surgery may have a beneficial effect in multimodal treatment of oligometastatic lung cancer. A prospective randomized study is necessary and may be feasible.
Literatur
1.
Zurück zum Zitat Jemal A, Center MM, DeSantis C, Ward EM. Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiol Biomarkers Prev. 2010;19(8):1893–907.CrossRefPubMed Jemal A, Center MM, DeSantis C, Ward EM. Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiol Biomarkers Prev. 2010;19(8):1893–907.CrossRefPubMed
2.
3.
Zurück zum Zitat Sánchez de Cos Escuín J, Abal Arca J, Melchor Íñiguez R, Miravet Sorribes L, Núñez Ares A, Hernández Hernández JR, et al. Tumor, node and metastasis classification of lung cancer – M1a versus M1b – analysis of M descriptors and other prognostic factors. Lung Cancer. 2014;84(2):182–9.CrossRefPubMed Sánchez de Cos Escuín J, Abal Arca J, Melchor Íñiguez R, Miravet Sorribes L, Núñez Ares A, Hernández Hernández JR, et al. Tumor, node and metastasis classification of lung cancer – M1a versus M1b – analysis of M descriptors and other prognostic factors. Lung Cancer. 2014;84(2):182–9.CrossRefPubMed
4.
Zurück zum Zitat Nieder C, Tollali T, Reigstad A, Pawinski A, Haukland E, Dalhaug A. Oligometastatic non-small cell lung cancer: A significant entity outside of specialized cancer centers? Med Princ Pract. 2014;23(6):526–31.CrossRefPubMed Nieder C, Tollali T, Reigstad A, Pawinski A, Haukland E, Dalhaug A. Oligometastatic non-small cell lung cancer: A significant entity outside of specialized cancer centers? Med Princ Pract. 2014;23(6):526–31.CrossRefPubMed
5.
Zurück zum Zitat Plönes T, Osei-Agyemang T, Krohn A, Passlick B. Surgical treatment of extrapulmonary oligometastatic non-small cell lung cancer. Indian J Surg. 2012. doi:10.1007/s12262-012-0771-6. Plönes T, Osei-Agyemang T, Krohn A, Passlick B. Surgical treatment of extrapulmonary oligometastatic non-small cell lung cancer. Indian J Surg. 2012. doi:10.​1007/​s12262-012-0771-6.
6.
Zurück zum Zitat Cha YK, Lee HY, Ahn MJ, Choi YL, Lee JH, Park K, et al. Survival outcome assessed according to tumor burden and progression patterns in patients with epidermal growth factor receptor mutant lung adenocarcinoma undergoing epidermal growth factor receptor tyrosine kinase inhibitor therapy. Clin Lung Cancer. 2015;16(3):228–36.CrossRefPubMed Cha YK, Lee HY, Ahn MJ, Choi YL, Lee JH, Park K, et al. Survival outcome assessed according to tumor burden and progression patterns in patients with epidermal growth factor receptor mutant lung adenocarcinoma undergoing epidermal growth factor receptor tyrosine kinase inhibitor therapy. Clin Lung Cancer. 2015;16(3):228–36.CrossRefPubMed
7.
Zurück zum Zitat Tseng SE, Chiou YY, Lee YC, Perng RP, Jacqueline WP, Chen YM. Number of liver metastatic nodules affects treatment options for pulmonary adenocarcinoma patients with liver metastases. Lung Cancer. 2014;86(2):225–30.CrossRefPubMed Tseng SE, Chiou YY, Lee YC, Perng RP, Jacqueline WP, Chen YM. Number of liver metastatic nodules affects treatment options for pulmonary adenocarcinoma patients with liver metastases. Lung Cancer. 2014;86(2):225–30.CrossRefPubMed
9.
Zurück zum Zitat Hasselle MD, Haraf DJ, Rusthoven KE, Golden DW, Salgia R, Villaflor VM, et al. Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer. J Thorac Oncol. 2012;7(2):376–81.CrossRefPubMed Hasselle MD, Haraf DJ, Rusthoven KE, Golden DW, Salgia R, Villaflor VM, et al. Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer. J Thorac Oncol. 2012;7(2):376–81.CrossRefPubMed
10.
Zurück zum Zitat Groome PA, Bolejack V, Crowley JJ, Kennedy C, Krasnik M, Sobin LH, et al. The IASLC Lung Cancer Staging Project: Validation of the proposals for revision of the T, N, and M descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol. 2007;2(8):694–705.CrossRefPubMed Groome PA, Bolejack V, Crowley JJ, Kennedy C, Krasnik M, Sobin LH, et al. The IASLC Lung Cancer Staging Project: Validation of the proposals for revision of the T, N, and M descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol. 2007;2(8):694–705.CrossRefPubMed
11.
Zurück zum Zitat Travis WD, Colby TV, Corrin B. Histological typing of lung and pleural tumours (international histological classification of tumours). Heidelberg: Springer; 1999.CrossRef Travis WD, Colby TV, Corrin B. Histological typing of lung and pleural tumours (international histological classification of tumours). Heidelberg: Springer; 1999.CrossRef
12.
Zurück zum Zitat Brunelli A, Charloux A, Bolliger CT, Rocco G, Sculier JP, Varela G, et al. ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy). Eur Respir J. 2009;34(1):17–41.CrossRefPubMed Brunelli A, Charloux A, Bolliger CT, Rocco G, Sculier JP, Varela G, et al. ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy). Eur Respir J. 2009;34(1):17–41.CrossRefPubMed
13.
Zurück zum Zitat Billing PS, Miller DL, Allen MS, Deschamps C, Trastek VF, Pairolero PC. Surgical treatment of primary lung cancer with synchronous brain metastases. J Thorac Cardiovasc Surg. 2001;122(3):548–53.CrossRefPubMed Billing PS, Miller DL, Allen MS, Deschamps C, Trastek VF, Pairolero PC. Surgical treatment of primary lung cancer with synchronous brain metastases. J Thorac Cardiovasc Surg. 2001;122(3):548–53.CrossRefPubMed
14.
Zurück zum Zitat Bonnette P, Puyo P, Gabriel C, Giudicelli R, Regnard JF, Riquet M, et al. Surgical management of non-small cell lung cancer with synchronous brain metastases. Chest. 2001;119(5):1469–75.CrossRefPubMed Bonnette P, Puyo P, Gabriel C, Giudicelli R, Regnard JF, Riquet M, et al. Surgical management of non-small cell lung cancer with synchronous brain metastases. Chest. 2001;119(5):1469–75.CrossRefPubMed
15.
Zurück zum Zitat Pfannschmidt J, Dienemann H. Surgical treatment of oligometastatic non-small cell lung cancer. Lung Cancer. 2010;69(3):251–8.CrossRefPubMed Pfannschmidt J, Dienemann H. Surgical treatment of oligometastatic non-small cell lung cancer. Lung Cancer. 2010;69(3):251–8.CrossRefPubMed
16.
Zurück zum Zitat Salah S, Tanvetyanon T, Abbasi S. Metastatectomy for extra-cranial extra-adrenal non-small cell lung cancer solitary metastases: Systematic review and analysis of reported cases. Lung Cancer. 2012;75(1):9–14.CrossRefPubMed Salah S, Tanvetyanon T, Abbasi S. Metastatectomy for extra-cranial extra-adrenal non-small cell lung cancer solitary metastases: Systematic review and analysis of reported cases. Lung Cancer. 2012;75(1):9–14.CrossRefPubMed
17.
Zurück zum Zitat Tanvetyanon T, Robinson LA, Schell MJ, Strong VE, Kapoor R, Coit DG, et al. Outcomes of adrenalectomy for isolated synchronous versus metachronous adrenal metastases in non-small-cell lung cancer: A systematic review and pooled analysis. J Clin Oncol. 2008;26(7):1142–7.CrossRefPubMed Tanvetyanon T, Robinson LA, Schell MJ, Strong VE, Kapoor R, Coit DG, et al. Outcomes of adrenalectomy for isolated synchronous versus metachronous adrenal metastases in non-small-cell lung cancer: A systematic review and pooled analysis. J Clin Oncol. 2008;26(7):1142–7.CrossRefPubMed
Metadaten
Titel
Surgical approach is superior to palliative treatment in oligometastatic lung cancer
verfasst von
Till Plönes, MD
Alberto Lopez-Pastorini
Erich Stoelben
Publikationsdatum
01.12.2016
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 6/2016
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-016-0437-x

Weitere Artikel der Ausgabe 6/2016

European Surgery 6/2016 Zur Ausgabe