Survival outcomes for oligometastasis in resected non-small cell lung cancer.
Survival outcomes for oligometastasis in resected non-small cell lung cancer.
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DOI：
10.1177/0218492315596463
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发表时间：
2015-10-01
影响因子：
0.7
通讯作者：
Ikeda, Norihiko
中科院分区：
文献类型：
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作者：
Shimada, Yoshihisa;Saji, Hisashi;Ikeda, Norihiko
方法：回顾分析2000年1月至2011年12月272例非小细胞肺癌术后远处复发患者的临床资料。结果：远处复发76例(28%)，多发转移196例(72.0%)。47例(62%)接受局部治疗(手术治疗5例，放射治疗9例，局部和全身序贯治疗28例，放化疗5例)。多因素分析显示，高龄、非腺癌、无病间隔时间短、无肺转移、肝转移、骨转移和多发转移与复发后不良生存显著相关。对少转移患者的亚组分析显示，组织学和无瘤间隔时间对生存率有很大影响。吸烟史和组织学与肺少转移患者的生存率相关，而系统治疗和较长的无病间隔与脑少转移患者复发后生存率的增加有关。结论：本研究表明，少转移状态本身是一个重要的有利因素。优化个体化全身治疗，增加局部治疗，对非小细胞肺癌和少转移肺癌患者的治疗具有重要意义。
BACKGROUND: We investigated the factors associated with post-recurrence survival and the treatment for non-small-cell lung cancer patients with postoperative distant recurrence, especially oligometastasis.METHODS: We reviewed the data of 272 patients with distant recurrence who underwent resection of non-small-cell lung cancer from January 2000 through December 2011.RESULTS: The type of distant recurrence was classified as oligometastasis (n=76, 28%) or polymetastasis (n=196, 72%). Forty-seven (62%) patients with oligometastasis received local therapy (surgery 5, radiotherapy 9, sequential local and systemic therapy 28, chemoradiotherapy 5). Multivariate analysis revealed older age, non-adenocarcinoma, shorter disease-free interval, no pulmonary metastasis, liver metastases, bone metastases, and polymetastasis had significant associations with unfavorable post-recurrence survival. Subgroup analysis of patients with oligometastasis showed histology and disease-free interval had a great impact on survival. Smoking history and histology were associated with survival in patients with lung oligometastasis, whereas systemic treatment and longer disease-free interval were related to increased post-recurrence survival in those with brain oligometastasis.CONCLUSIONS: This study showed that an oligometastatic state per se was a significant favorable factor. Optimization of personalized systemic treatment and adding local treatment are important in the management of patients with non-small-cell lung cancer and oligometastasis.