Management of synchronous extrathoracic oligometastatic non-small cell lung cancer Journal Article


Authors: Jones, G. D.; Lengel, H. B.; Hsu, M.; Tan, K. S.; Caso, R.; Ghanie, A.; Connolly, J. G.; Bains, M. S.; Rusch, V. W.; Huang, J.; Park, B. J.; Gomez, D. R.; Jones, D. R.; Rocco, G.
Article Title: Management of synchronous extrathoracic oligometastatic non-small cell lung cancer
Abstract: Stage IV non-small cell lung cancer (NSCLC) accounts for 35 to 40% of newly diagnosed cases of NSCLC. The oligometastatic state—≤5 extrathoracic metastatic lesions in ≤3 organs—is present in ~25% of patients with stage IV disease and is associated with markedly improved outcomes. We retrospectively identified patients with extrathoracic oligometastatic NSCLC who underwent primary tumor resection at our institution from 2000 to 2018. Event-free survival (EFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Factors associated with EFS and OS were determined using Cox regression. In total, 111 patients with oligometastatic NSCLC underwent primary tumor resection; 87 (78%) had a single metastatic lesion. Local consolidative therapy for metastases was performed in 93 patients (84%). Seventy-seven patients experienced recurrence or progression. The five-year EFS was 19% (95% confidence interval (CI), 12–29%), and the five-year OS was 36% (95% CI, 27–50%). Factors independently associated with EFS were primary tumor size (hazard ratio (HR), 1.15 (95% CI, 1.03–1.29); p = 0.014) and lymphovascular invasion (HR, 1.73 (95% CI, 1.06–2.84); p = 0.029). Factors independently associated with OS were neoadjuvant therapy (HR, 0.43 (95% CI, 0.24–0.77); p = 0.004), primary tumor size (HR, 1.18 (95% CI, 1.02–1.35); p = 0.023), pathologic nodal disease (HR, 1.83 (95% CI, 1.05–3.20); p = 0.033), and visceral-pleural invasion (HR, 1.93 (95% CI, 1.10–3.40); p = 0.022). Primary tumor resection represents an important treatment option in the multimodal management of extrathoracic oligometastatic NSCLC. Encouraging long-term survival can be achieved in carefully selected patients, including those who received neoadjuvant therapy and those with limited intrathoracic disease. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Keywords: non-small cell lung cancer; oligometastasis; primary tumor resection
Journal Title: Cancers
Volume: 13
Issue: 8
ISSN: 2072-6694
Publisher: MDPI  
Date Published: 2021-04-01
Start Page: 1893
Language: English
DOI: 10.3390/cancers13081893
PROVIDER: scopus
PMCID: PMC8071146
PUBMED: 33920810
DOI/URL:
Notes: Article -- Export Date: 3 May 2021 -- Source: Scopus
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MSK Authors
  1. Meier Hsu
    136 Hsu
  2. Valerie W Rusch
    752 Rusch
  3. Daniel R Gomez
    78 Gomez
  4. James Huang
    150 Huang
  5. Bernard J Park
    191 Park
  6. Manjit S Bains
    278 Bains
  7. David Randolph Jones
    240 Jones
  8. Kay See   Tan
    139 Tan
  9. Gregory Jones
    12 Jones
  10. Raul Caso Jr
    12 Caso Jr
  11. Gaetano Rocco
    39 Rocco
  12. Harry Benjamin Lengel
    1 Lengel