An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non-small-cell lung cancer

Allison B. Ashworth; Suresh Senan; David A. Palma; Marc Riquet; Yong Chan Ahn; Umberto Ricardi; Maria T. Congedo; Daniel R. Gomez; Gavin M. Wright; Giulio Melloni; Michael T. Milano; Claudio V. Sole; Tommaso M. De Pas; Dennis L. Carter; Andrew J. Warner; George B. Rodrigues

doi:10.1016/j.cllc.2014.04.003

An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non-small-cell lung cancer

Allison B. Ashworth, Suresh Senan, David A. Palma, Marc Riquet, Yong Chan Ahn, Umberto Ricardi, Maria T. Congedo, Daniel R. Gomez, Gavin M. Wright, Giulio Melloni, Michael T. Milano, Claudio V. Sole, Tommaso M. De Pas, Dennis L. Carter, Andrew J. Warner, George B. Rodrigues

Istituto Europeo di Oncologia

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction/Background An individual patient data metaanalysis was performed to determine clinical outcomes, and to propose a risk stratification system, related to the comprehensive treatment of patients with oligometastatic NSCLC.

Materials and Methods After a systematic review of the literature, data were obtained on 757 NSCLC patients with 1 to 5 synchronous or metachronous metastases treated with surgical metastectomy, stereotactic radiotherapy/radiosurgery, or radical external-beam radiotherapy, and curative treatment of the primary lung cancer, from hospitals worldwide. Factors predictive of overall survival (OS) and progression-free survival were evaluated using Cox regression. Risk groups were defined using recursive partitioning analysis (RPA). Analyses were conducted on training and validating sets (two-thirds and one-third of patients, respectively).

Results Median OS was 26 months, 1-year OS 70.2%, and 5-year OS 29.4%. Surgery was the most commonly used treatment for the primary tumor (635 patients [83.9%]) and metastases (339 patients [62.3%]). Factors predictive of OS were: synchronous versus metachronous metastases (P

Conclusion Significant OS differences were observed in oligometastatic patients stratified according to type of metastatic presentation, and N status. Long-term survival is common in selected patients with metachronous oligometastases. We propose this risk classification scheme be used in guiding selection of patients for clinical trials of ablative treatment.

Original language	English
Pages (from-to)	346-355
Number of pages	10
Journal	Clinical Lung Cancer
Volume	15
Issue number	5
DOIs	https://doi.org/10.1016/j.cllc.2014.04.003
Publication status	Published - Sep 1 2014

Keywords

Metastectomy
NSCLC
Oligometastases
Radiotherapy
SABR/SBRT

ASJC Scopus subject areas

Cancer Research
Oncology
Pulmonary and Respiratory Medicine
Medicine(all)

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Ashworth, A. B., Senan, S., Palma, D. A., Riquet, M., Ahn, Y. C., Ricardi, U., Congedo, M. T., Gomez, D. R., Wright, G. M., Melloni, G., Milano, M. T., Sole, C. V., De Pas, T. M., Carter, D. L., Warner, A. J., & Rodrigues, G. B. (2014). An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non-small-cell lung cancer. Clinical Lung Cancer, 15(5), 346-355. https://doi.org/10.1016/j.cllc.2014.04.003

An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non-small-cell lung cancer. / Ashworth, Allison B.; Senan, Suresh; Palma, David A.; Riquet, Marc; Ahn, Yong Chan; Ricardi, Umberto; Congedo, Maria T.; Gomez, Daniel R.; Wright, Gavin M.; Melloni, Giulio; Milano, Michael T.; Sole, Claudio V.; De Pas, Tommaso M.; Carter, Dennis L.; Warner, Andrew J.; Rodrigues, George B.

In: Clinical Lung Cancer, Vol. 15, No. 5, 01.09.2014, p. 346-355.

Research output: Contribution to journal › Article › peer-review

Ashworth, AB, Senan, S, Palma, DA, Riquet, M, Ahn, YC, Ricardi, U, Congedo, MT, Gomez, DR, Wright, GM, Melloni, G, Milano, MT, Sole, CV, De Pas, TM, Carter, DL, Warner, AJ & Rodrigues, GB 2014, 'An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non-small-cell lung cancer', Clinical Lung Cancer, vol. 15, no. 5, pp. 346-355. https://doi.org/10.1016/j.cllc.2014.04.003

Ashworth, Allison B. ; Senan, Suresh ; Palma, David A. ; Riquet, Marc ; Ahn, Yong Chan ; Ricardi, Umberto ; Congedo, Maria T. ; Gomez, Daniel R. ; Wright, Gavin M. ; Melloni, Giulio ; Milano, Michael T. ; Sole, Claudio V. ; De Pas, Tommaso M. ; Carter, Dennis L. ; Warner, Andrew J. ; Rodrigues, George B. / An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non-small-cell lung cancer. In: Clinical Lung Cancer. 2014 ; Vol. 15, No. 5. pp. 346-355.

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abstract = "Introduction/Background An individual patient data metaanalysis was performed to determine clinical outcomes, and to propose a risk stratification system, related to the comprehensive treatment of patients with oligometastatic NSCLC.Materials and Methods After a systematic review of the literature, data were obtained on 757 NSCLC patients with 1 to 5 synchronous or metachronous metastases treated with surgical metastectomy, stereotactic radiotherapy/radiosurgery, or radical external-beam radiotherapy, and curative treatment of the primary lung cancer, from hospitals worldwide. Factors predictive of overall survival (OS) and progression-free survival were evaluated using Cox regression. Risk groups were defined using recursive partitioning analysis (RPA). Analyses were conducted on training and validating sets (two-thirds and one-third of patients, respectively).Results Median OS was 26 months, 1-year OS 70.2%, and 5-year OS 29.4%. Surgery was the most commonly used treatment for the primary tumor (635 patients [83.9%]) and metastases (339 patients [62.3%]). Factors predictive of OS were: synchronous versus metachronous metastases (P Conclusion Significant OS differences were observed in oligometastatic patients stratified according to type of metastatic presentation, and N status. Long-term survival is common in selected patients with metachronous oligometastases. We propose this risk classification scheme be used in guiding selection of patients for clinical trials of ablative treatment.",

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AU - Ashworth, Allison B.

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AU - Palma, David A.

AU - Riquet, Marc

AU - Ahn, Yong Chan

AU - Ricardi, Umberto

AU - Congedo, Maria T.

AU - Gomez, Daniel R.

AU - Wright, Gavin M.

AU - Melloni, Giulio

AU - Milano, Michael T.

AU - Sole, Claudio V.

AU - De Pas, Tommaso M.

AU - Carter, Dennis L.

AU - Warner, Andrew J.

AU - Rodrigues, George B.

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N2 - Introduction/Background An individual patient data metaanalysis was performed to determine clinical outcomes, and to propose a risk stratification system, related to the comprehensive treatment of patients with oligometastatic NSCLC.Materials and Methods After a systematic review of the literature, data were obtained on 757 NSCLC patients with 1 to 5 synchronous or metachronous metastases treated with surgical metastectomy, stereotactic radiotherapy/radiosurgery, or radical external-beam radiotherapy, and curative treatment of the primary lung cancer, from hospitals worldwide. Factors predictive of overall survival (OS) and progression-free survival were evaluated using Cox regression. Risk groups were defined using recursive partitioning analysis (RPA). Analyses were conducted on training and validating sets (two-thirds and one-third of patients, respectively).Results Median OS was 26 months, 1-year OS 70.2%, and 5-year OS 29.4%. Surgery was the most commonly used treatment for the primary tumor (635 patients [83.9%]) and metastases (339 patients [62.3%]). Factors predictive of OS were: synchronous versus metachronous metastases (P Conclusion Significant OS differences were observed in oligometastatic patients stratified according to type of metastatic presentation, and N status. Long-term survival is common in selected patients with metachronous oligometastases. We propose this risk classification scheme be used in guiding selection of patients for clinical trials of ablative treatment.

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