scholarly journals Management of Synchronous Extrathoracic Oligometastatic Non-Small Cell Lung Cancer

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1893
Author(s):  
Gregory D. Jones ◽  
Harry B. Lengel ◽  
Meier Hsu ◽  
Kay See Tan ◽  
Raul Caso ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Tumor Size ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Small Cell ◽  
Primary Tumor Resection ◽  
Small Cell Lung ◽  
Primary Tumor Size

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.

Impact of primary tumor resection in oligometastatic non-small cell lung cancer: Experience of a resource-limited cancer center in southern Brazil.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20552-e20552
Author(s):  
Paulo Ricardo Santos Nunes Filho ◽  
Caroline Albuquerque Moreira da Silva ◽  
Maria Teresa Ruiz Tsukazan ◽  
Andre Poisl Fay ◽  
Carlos H. Barrios ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Clinical Benefit ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Local Therapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Resource Limited

e20552 Background: Stage IV non-small cell lung cancer (NSCLC) with low volume disease represents a more indolent phenotype within the biological spectrum of lung cancer. Recent data suggest that aggressive local therapy may impact clinical benefit in this subgroup of patients, with 5-year overall survival (OS) rate around 20%. Methods: We analyzed patients with oligometetastatic (≤3 metastasis) NSCLC treated with primary tumor resection at Hospital São Lucas da PUCRS. Clinico-pathological features and survival data were retrospectively collected using standard templates. The primary endpoint was OS. Survival was estimated using the Kaplan-Meier method and log-rank test was used to univariate analysis. Results: Between April 1991 and December 2015, 25 patients with oligometastatic NSCLC underwent surgery of the primary tumor. Clinico-pathological data are summarized in Table 1. Overall, median OS was 16 months (95% CI: 8.87-23.13 months) with a 5-years survival rate of 7%. Age less than 65 years old was associated with longer OS (HR 0.34 95%CI 0.13-0.92 p = 0.02). Patients with brain metastasis had a non-significant lower OS than those without (16 vs. 24 months, respectively). Conclusions: This analysis suggests that in a resource-limited center, where immunotherapies and targeted-therapies are not available, local therapy for oligometastatic NSCLC did not provide the same clinical benefit seen in the same population from high-income countries. See table. [Table: see text]

scholarly journals Can positron emission tomography - computed tomography imaging predict of metastases in patients with small cell lung cancer

2020 ◽  
Vol 8 (5) ◽  
pp. 1644
Author(s):  
Ngo Minh Xuan ◽  
Huynh Quang Huy
Keyword(s):  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Small Cell Lung Cancer ◽  
Tumor Size ◽  
Primary Tumor ◽  
Small Cell ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Positron Emission ◽  
Pet Ct

Background: Small-cell lung cancer (SCLC) accounts for 15%-20% of all lung cancer cases. positron emission tomography - computed tomography (PET/CT) has become increasingly used as an initial staging tool in patients with SCLC. We aimed to explore the relationships between primary tumor 18F-FDG uptake measured as the maximum standardized uptake value (SUV max) and clinical stage at PET/CT for small cell lung cancer patients (SCLC).Methods: Patients with SCLC who underwent 18F-FDG PET/CT scans before the treatment were included in the study at Bach Mai hospital of Vietnam, from November 2014 to May 2018. The primary tumor and secondary lesion SUVmax was calculated; the tumor size was measured; the TNM status was determined mainly by FDG PET/CT imaging according to The 8th Edition of the TNM Classification for Lung Cancer were recorded. An evaluation was made of the linear relationship between tumor size, T stage, N stage, and M stages of the patients and their SUVmax using Spearman’s correlation.Results: Total 37 cases (34 men and 3 women; age range 38 - 81 years, median 64 years) were analyzed. The average of primary tumor size and SUVmax were 5.95±2.77 cm and 10.21±4.75, respectively. The SUVmax of primary tumor is significantly greater than that of nodal and distant organ metastasis (10.21±4.75 vs 8.20±4.35 and 6.44±3.17, p<0.01). There was a moderate correlation between SUVmax and tumor size (r =0.596, p<0.001), tumor stage (r = 0.502, p<0.01) but not significant with nodal stage (r =-0.218, p=0.194), metastasis stage (r = -0.055, p=0.747), and overall stage (r=-0.060, p=0.725).Conclusions: SUVmax was significantly correlated with tumor size, but not with distant metastases or lymph node involvement. Therefore, SUVmax on positron emission tomography is not predictive of the presence of metastases in patients with SCLC.

Musashi 2 (MSI2) expression as an independent prognostic biomarker in non-small cell lung cancer (NSCLC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21583-e21583
Author(s):  
Alexander Deneka ◽  
Leonid Kharin ◽  
Nikolay S. Karnaukhov ◽  
Mark Voloshin ◽  
Tamara G. Ayrapetova ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Primary Tumor ◽  
Normal Tissue ◽  
Prognostic Biomarker ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
Correlative Analysis

e21583 Background: Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death in the world, and metastasis is the most common cause of death in lung cancer patients. Musashi-2 (MSI2) is a member of RNA-binding protein family and regulates mRNA translation of numerous intracellular targets, and influences multiple biological processes, including maintenance of stem cell identity. Previously we reported that MSI2 is upregulated in the metastasis-competent NSCLC murine and human cell lines, drives NSCLC metastasis, and is progressively elevated in lung cancer patient samples. This study assessed MSI2 as potential clinical biomarker in NSCLC. Methods: The current study included 40 patients with NSCLC, of whom 15 presented with stage II and III respectively (37,5% each), and 10 patients (25%) had stage IV. All patients received treatment in accordance with the NCCN guidelines, and did not participate in clinical trials. All patient samples were obtained before treatment started. We used immunohistochemical (IHC) approach to measure MSI2 expression on the protein level in matching specimens of normal versus tumor tissues, and primary tumor vs. metastasis, followed by correlative analysis in relation to clinical outcomes. In parallel, clinical correlative analysis of MSI2 mRNA expression was performed in silico using publicly available datasets (TCGA/ICGC) as of January 2020. Results: MSI2 protein expression in patient samples was significantly elevated in NSCLC primary tumors and metastatic sites versus normal tissue (p = 0.03). MSI2 elevated expression positively correlated with a decreased progression free survival (PFS) (p = 0.026) at all stages and overall survival at stage IV (p = 0.013). Elevated MSI2 expression on RNA level was observed in primary tumor versus normal tissue samples in TCGA (p < 0.0001), and positively correlated with decreased OS (p = 0.028). No correlation was observed between MSI2 expression and age, sex, smoking, and treatment type. Conclusions: Elevated MSI2 expression in primary NSCLC tumors is associated with poor prognosis and can be used as a novel potential prognostic biomarker in NSCLC patients. Future studies in an extended patient cohort are strongly warranted.

Sign in / Sign up

Export Citation Format

Share Document