Prognostic Impact of Local Treatment Against Postoperative Oligometastases in Non-Small Cell Lung Cancer
Prognostic Impact of Local Treatment Against Postoperative Oligometastases in Non-Small Cell Lung Cancer
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DOI：
10.1002/jso.21750
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发表时间：
2010-12-01
影响因子：
2.5
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
--
作者：
Yano, Tokujiro;Haro, Akira;Maehara, Yoshihiko
目的：本研究探讨手术切除的非小细胞肺癌（NSCLC）远处转移复发后影响生存的预后因素，阐明局部治疗对少转移性复发预后的影响。方法：从1994年到2004年，418例连续的NSCLC患者接受了完全切除；到2005年12月，138例术后复发。其中，我们回顾了93例仅远处转移的患者的临床病理信息、治疗方式和生存率。结果：93例单纯远处转移患者，复发后2年和5年生存率分别为43.9%和38.7%。在这些患者中，44人首先接受局部治疗，其中31人接受放射治疗，13人接受手术切除。他们的复发性疾病（低转移）是有限的，有可能通过局部治疗得到控制。14例患者的目标转移器官是脑，14例是骨，12例是肺，4例是其他器官。影响复发后生存的重要预后因素包括腺癌组织学、长无病间期（DFI）（1年或更长）以及对低转移灶的局部治疗。结论：对于术后少转移性复发患者，尤其是DR≥1年的患者，放疗和手术等局部治疗可作为一线治疗。中华外科杂志，2010;32(2):851 -855。(C) 2010 Wiley-Liss, Inc。
Objectives: In this study, we investigated prognostic factors associated with survival after distantly metastatic recurrence in surgically resected non-small cell lung cancer (NSCLC), and clarified the influence of local treatment on the prognosis for oligometastatic recurrence.Methods: From 1994 through 2004, 418 consecutive patients with NSCLC underwent complete resection; 138 experienced a postoperative recurrence by December 2005. Of those, we reviewed 93 patients with only distant metastases for clinicopathological information, treatment modality, and survival.Results: For the 93 patients with distant metastasis alone, the 2- and 5-year survival rates after recurrence were 43.9% and 38.7%, respectively. Of those patients, 44 first received local treatment, including radiotherapy in 31 and a surgical resection in 13. Their recurrent disease (oligometastases) was limited with the potential to be controlled with local treatment. The targeted metastatic organs were brain in 14 patients, bone in 14, lungs in 12, and other organs in 4. Significant prognostic factors for postrecurrence survival included adenocarcinoma histology, long disease-free interval (DFI) (1 year or longer), and the performance of local treatment for oligometastases.Conclusion: Local therapy such as radiotherapy and surgery, might be considered first-line treatment in patients with postoperative oligometastatic recurrence, especially those with a DR >= 1 year. J. Surg. Oncol. 2010;102:852-855. (C) 2010 Wiley-Liss, Inc.