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

Research output: Contribution to journalArticlepeer-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 languageEnglish
Pages (from-to)346-355
Number of pages10
JournalClinical Lung Cancer
Volume15
Issue number5
DOIs
Publication statusPublished - 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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