A risk stratification scheme for synchronous oligometastatic non-small cell lung cancer developed by a multicentre analysis

Autor: Marco Lucchi, Lorena Costardi, Angelo Morelli, Domenico Viggiano, Angela De Palma, Filippo Tommaso Gallina, Michele Rusca, Giovanni Muriana, Silvia Ceccarelli, Andrea De Vico, Lorenzo Spaggiari, Giuseppe Marulli, Roberto Crisci, Angelo Carretta, Lorenzo Rosso, Enrico Ruffini, Paolo Mendogni, Francesco Puma, Luigi Ventura, Francesco Londero, Luca Bertolaccini, Edoardo Bottoni, Federico Rea, Marco Alloisio, Giuseppe Cardillo, Marco Schiavon, Maria Teresa Congedo, Nicola Tamburini, Pio Maniscalco, Giampiero Negri, Francesco Facciolo, Sara Ricciardi, Stefano Margaritora, Stefano Bongiolatti, Ilaria Ceccarelli, Luca Voltolini
Přispěvatelé: Spaggiari, Lorenzo, Bertolaccini, Luca, Facciolo, Francesco, Tommaso Gallina, Filippo, Rea, Federico, Schiavon, Marco, Margaritora, Stefano, Congedo, Mariateresa, Lucchi, Marco, Ceccarelli, Ilaria, Alloisio, Marco, Bottoni, Edoardo, Negri, Giampiero, Carretta, Angelo, Cardillo, Giuseppe, Ricciardi, Sara, Ruffini, Enrico, Costardi, Lorena, Muriana, Giovanni, Viggiano, Domenico, Rusca, Michele, Ventura, Luigi, Marulli, Giuseppe, De Palma, Angela, Rosso, Lorenzo, Mendogni, Paolo, Crisci, Roberto, De Vico, Andrea, Maniscalco, Pio, Tamburini, Nicola, Puma, Francesco, Ceccarelli, Silvia, Voltolini Stefano Bongiolatti, Luca, Morelli, Angelo, Londero, Francesco
Rok vydání: 2021
Předmět:
Zdroj: Lung Cancer. 154:29-35
ISSN: 0169-5002
DOI: 10.1016/j.lungcan.2021.02.001
Popis: Backgrounds Oligometastatic Non-Small Cell Lung Cancer (NSCLC) patients represent a category without a standard therapeutic approach. However, in selected oligometastatic NSCLC, radical surgery seems to offer a good prognosis. This retrospective study aimed to analyse the long-term outcomes of synchronous oligometastatic patients treated with curative intent and identify the factors associated with better results and the proposal of a risk stratification system for classifying the synchronous oligometastatic NSCLC. Methods The medical records of patients from 18 centres with pathologically diagnosed synchronous oligometastatic NSCLC were retrospectively reviewed. The inclusion criteria were synchronous oligometastatic NSCLC, radical surgical treatment of the primary tumour with or without neoadjuvant/adjuvant therapy and radical treatment of all metastatic sites. The Kaplan – Meier method estimated survivals. A stratified backward stepwise Cox regression model was assessed for multivariable survival analyses. Results 281 patients were included. The most common site of metastasis was the brain, in 50.89 % patients. Median overall survival was 40 months (95 % CI: 29–53). Age ≤65 years (HR = 1.02, 95 % CI: 1.00–1.05; p = 0.019), single metastasis (HR = 0.71, 95 % CI: 0.45–1.13; p = 0.15) and presence of contralateral lung metastases (HR = 0.30, 95 % CI: 0.15 – 0.62; p = 0.001) were associated with a good prognosis. The presence of pathological N2 metastases negatively affected survival (HR = 2.00, 95 % CI: 1.21–3.32; p = 0.0065). These prognostic factors were used to build a simple risk classification scheme. Conclusions Treatment of selected synchronous oligometastatic NSCLC with curative purpose could be conducted safely and at acceptable 5-year survival levels, especially in younger patients with pN0 disease.
Databáze: OpenAIRE
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