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Metachronous oligometastatic non-small cell lung cancer: are we selecting the appropriate patients for radical treatment?
Cheng, A. Craig, C. Summers, Yvonne J Taylor, Paul Califano, Raffaele Cove-Smith, Laura Woolf, David K Duerden, R. Sharman, A. Lyons, J.
Cheng, A.
Craig, C.
Summers, Yvonne J
Taylor, Paul
Califano, Raffaele
Cove-Smith, Laura
Woolf, David K
Duerden, R.
Sharman, A.
Lyons, J.
Citations
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Abstract
Introduction: Arguments can be made for MDTs to consider radical
intent treatment in selected cases of metachronous oligometastatic
NSCLC due to potential longer-term survival and disease control.
A large meta-analysis found that metachronous presentation due to disease progression and failed adrenalectomy (found to be
unresectable intra-operatively). In the 7 patients that completed
radical intent treatment the 90-day mortality was 0%. Conclusion: Metachronous oligometastatic NSCLC makes up a very
small fraction of our MDT discussions (0.6%). The majority of our
patients had good performance status following radical treatment
of their primary tumour (90%). The majority are recommended
for radical intent treatment (90%) and the majority complete this
treatment course (78%). 90-day mortality is 0% though conclusions
from this are limited considering the small patient size. However,
the results do suggest we are selecting appropriate patients with
metachronous oligometastatic NSCLC for radical intent treatment
within the MDT.
positively affected survival. We sought to analyse our own MDT's
practice in this cohort of patients.
Methods: A retrospective review of our electronic lung cancer MDT
database at Wythenshawe Hospital, South Manchester, between
April 2016 and April 2018. We selected patients with metachronous
oligometastatic NSCLC (single metastasis in a single organ) and
recorded patient demographics, performance status, nodal staging,
pathology, and site of metastases. MDT recommendations were
compared to treatment received and we calculated 90-day mortality
following completed treatment.
Results: 1754 individual MDT cases were identified. Metachronous
oligometastatic NSCLC was found in 10 (0.6%) patients (Table 1). The
adrenal and brain were the commonest site of metastasis (7/10, 70%).
Nine (90%) patients were recommended for radical-intent treatment
including 8 (89%) surgical metastectomies. In 4 (44%) patients additional
systemic anti-cancer treatment was recommended following
treatment to the metastatic lesion. Treatment was completed
in 7 out of 9 patients (78%). Failure to complete treatment was
Description
Date
2019
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Cheng A, Craig C, Summers Y, Taylor P, Califano R, Cove-Smith L, et al. Metachronous oligometastatic non-small cell lung cancer: are we selecting the appropriate patients for radical treatment? Lung Cancer. 2019;127:S36-S.