Patient outcomes post-pulmonary resection for synchronous bone-metastatic non-small cell lung cancer.

Surgery bone metastasis non-small cell lung cancer (NSCLC)

Journal

Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916

Informations de publication

Date de publication:
Sep 2019
Historique:
entrez: 29 10 2019
pubmed: 28 10 2019
medline: 28 10 2019
Statut: ppublish

Résumé

The efficacy of curative-intent pulmonary resection for non-small cell lung cancer (NSCLC) patients with certain types of oligometastases, particularly brain and adrenal metastases, has previously been described. We investigated the outcomes of curative-intent pulmonary resection for NSCLC patients with synchronous isolated bone metastases, which have been less clear to date. We retrospectively reviewed the clinical and pathological records of 41 patients with NSCLC and synchronous isolated bone metastases who underwent radical treatments (surgery and/or chemotherapy and/or radiotherapy) for both their primary tumors and bone metastases at the National Hospital Organization, Hokkaido Cancer Center, between 2008 and 2013. Nine of the 41 patients underwent pulmonary primary tumor resection; the rate of clinical N0-1 disease among these 9 patients (100%) was significantly higher than that among the 32 patients who did not undergo resection (34.4%). The five-year overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) rates of the nine patients who underwent pulmonary resection were 66.7%, 55.6%, and 44.4%, respectively. On multivariate analysis, the predictors of longer OS among all 41 patients were primary site resection [hazard ratio (HR) =4.18, 95% CI, 1.20-14.6, P=0.025] and epidermal growth factor receptor (EGFR) mutation (HR =3.30, 95% CI, 1.08-10.1, P=0.036). The former was also a predictor of longer PFS (HR =3.75, 95% CI, 1.27-11.0, P=0.016). Patients with clinical N0-1 NSCLC and synchronous isolated bone metastases may achieve longer survival rates following primary lung tumor resection.

Sections du résumé

BACKGROUND BACKGROUND
The efficacy of curative-intent pulmonary resection for non-small cell lung cancer (NSCLC) patients with certain types of oligometastases, particularly brain and adrenal metastases, has previously been described. We investigated the outcomes of curative-intent pulmonary resection for NSCLC patients with synchronous isolated bone metastases, which have been less clear to date.
METHODS METHODS
We retrospectively reviewed the clinical and pathological records of 41 patients with NSCLC and synchronous isolated bone metastases who underwent radical treatments (surgery and/or chemotherapy and/or radiotherapy) for both their primary tumors and bone metastases at the National Hospital Organization, Hokkaido Cancer Center, between 2008 and 2013.
RESULTS RESULTS
Nine of the 41 patients underwent pulmonary primary tumor resection; the rate of clinical N0-1 disease among these 9 patients (100%) was significantly higher than that among the 32 patients who did not undergo resection (34.4%). The five-year overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) rates of the nine patients who underwent pulmonary resection were 66.7%, 55.6%, and 44.4%, respectively. On multivariate analysis, the predictors of longer OS among all 41 patients were primary site resection [hazard ratio (HR) =4.18, 95% CI, 1.20-14.6, P=0.025] and epidermal growth factor receptor (EGFR) mutation (HR =3.30, 95% CI, 1.08-10.1, P=0.036). The former was also a predictor of longer PFS (HR =3.75, 95% CI, 1.27-11.0, P=0.016).
CONCLUSIONS CONCLUSIONS
Patients with clinical N0-1 NSCLC and synchronous isolated bone metastases may achieve longer survival rates following primary lung tumor resection.

Identifiants

pubmed: 31656656
doi: 10.21037/jtd.2019.09.17
pii: jtd-11-09-3836
pmc: PMC6790437
doi:

Types de publication

Journal Article

Langues

eng

Pagination

3836-3845

Informations de copyright

2019 Journal of Thoracic Disease. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: The authors have no conflicts of interest to declare.

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Auteurs

Yuki Takahashi (Y)

Department of Thoracic Surgery, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
Department of Thoracic Surgery, Sapporo Medical University, School of Medicine and Hospital, Sapporo, Japan.

Hirofumi Adachi (H)

Department of Thoracic Surgery, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.

Yasushi Mizukami (Y)

Department of Thoracic Surgery, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.

Hiroshi Yokouchi (H)

Department of Respiratory Medicine, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.

Satoshi Oizumi (S)

Department of Respiratory Medicine, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.

Atsushi Watanabe (A)

Department of Thoracic Surgery, Sapporo Medical University, School of Medicine and Hospital, Sapporo, Japan.

Classifications MeSH