Metachronous oligometastatic non-small cell lung cancer: are we selecting the appropriate patients for radical treatment?
Summers, Yvonne J
Woolf, David K
Crosbie, P. A. J.
AffiliationRespiratory Medicine, Manchester University NHS Foundation Trust, Manchester,
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AbstractIntroduction: 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
CitationCheng 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.
TypeMeetings and Proceedings