NEW YORK (Reuters Health) Sep 30 - In the rare patient with non-small cell lung cancer with solitary metastasis not involving the brain or adrenal glands, resection can have an encouraging outcome, researchers report August 23 online in Lung Cancer.
"The findings of this study," senior author Dr. Salah Abbasi told Reuters Health by email, "give great hope to lung cancer patients with solitary metastasis; they can be treated now with curative intent instead of palliative intent."
Dr. Abbasi of the King Hussein Cancer Center in Amman, Jordan, and colleagues note that patients with solitary brain or adrenal metastasis have more favorable outcomes following surgical resection. Nevertheless, they add, "the outcome and predictive factors for survival following metastasectomy for patients with other metastatic sites are not well defined."
To gain more information, the team examined the literature and identified 51 articles involving 75 patients. After exclusions, 62 cases remained eligible for review and analysis.
Overall, the 5-year survival rate was 50%. Patients with non-visceral metastasis had a 5-year survival of 63%, compared to 39% for patients with visceral metastasis.
Smaller or larger primary tumors had no significant influence on survival, nor did sex, histology or the use of perioperative chemotherapy. However, patients with mediastinal lymph node involvement had a mean survival of 23 months compared to 75 months for the other patients. In fact, no patients with such involvement survived for 5 years, while 64% of other patients did.
Similarly, there were no 5-year survivals in patients with intra-thoracic stage III disease, compared to 77% for stage II and 63% for stage I. Their mean survival time was 23 months.
Overall, these patients, "especially if they have stage I or II intrathoracic tumor," say the investigators, "should be offered metastasectomy after complete and meticulous staging of the mediastinum and other distant sites."
Thus concluded Dr. Abbasi, "Oncologists treating lung cancer patients with solitary metastasis should look aggressively for the possibility of curative resection of the metastatic site and definitive treatment of the lung primary; these patients have a survival chance similar to patients who present as stage II disease."
SOURCE: http://bit.ly/pSaIzv
Lung Cancer 2011.
"The findings of this study," senior author Dr. Salah Abbasi told Reuters Health by email, "give great hope to lung cancer patients with solitary metastasis; they can be treated now with curative intent instead of palliative intent."
Dr. Abbasi of the King Hussein Cancer Center in Amman, Jordan, and colleagues note that patients with solitary brain or adrenal metastasis have more favorable outcomes following surgical resection. Nevertheless, they add, "the outcome and predictive factors for survival following metastasectomy for patients with other metastatic sites are not well defined."
To gain more information, the team examined the literature and identified 51 articles involving 75 patients. After exclusions, 62 cases remained eligible for review and analysis.
Overall, the 5-year survival rate was 50%. Patients with non-visceral metastasis had a 5-year survival of 63%, compared to 39% for patients with visceral metastasis.
Smaller or larger primary tumors had no significant influence on survival, nor did sex, histology or the use of perioperative chemotherapy. However, patients with mediastinal lymph node involvement had a mean survival of 23 months compared to 75 months for the other patients. In fact, no patients with such involvement survived for 5 years, while 64% of other patients did.
Similarly, there were no 5-year survivals in patients with intra-thoracic stage III disease, compared to 77% for stage II and 63% for stage I. Their mean survival time was 23 months.
Overall, these patients, "especially if they have stage I or II intrathoracic tumor," say the investigators, "should be offered metastasectomy after complete and meticulous staging of the mediastinum and other distant sites."
Thus concluded Dr. Abbasi, "Oncologists treating lung cancer patients with solitary metastasis should look aggressively for the possibility of curative resection of the metastatic site and definitive treatment of the lung primary; these patients have a survival chance similar to patients who present as stage II disease."
SOURCE: http://bit.ly/pSaIzv
Lung Cancer 2011.
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