Survival of M1a Non-Small Cell Lung Cancer Treated Surgically: A Retrospective Single-Center Study.

Stage IV non-small cell lung cancer (NSCLC) is always associated with a poor outcome and is rarely treated with surgical resection. The aim of this study was to retrospectively analyze the effectiveness of surgical treatments. We have retrospectively analyzed the records of NSCLC patients with local thoracic metastatic disease (M1a) who had been treated with surgical resection. The impact on survival of eight variables (age, gender, smoking status, current drinking status, site of metastasis, pathology classifications, resection status, and presence of adjuvant treatment) were further assessed. Eighty patients (49 males, 61%) with a median age of 58 (range, 38-80) were included. Metastatic sites included: pleural nodules with or without effusion metastasis (51, 63.8%), pleural effusion without nodules (7, 8.8%), contralateral lung (9, 11.3%), diaphragm nodules metastasis (5, 6.3%), and pericardium nodules metastasis (8, 10%). Histology was adenocarcinoma in 55, squamous-cell carcinoma in 16, large cell in 5 and other in 4 patients. Types of lung resection performed for primary tumors were complete resection in 43 and limited resection in 37 patients. Survival at 5 years for the overall population reached 31% (95% confidence interval, 19.4-43%). The median overall survival time was 34.3 months. Ten (12.5%) patients survived for more than 5 years. Smoking status and postoperative adjuvant treatment were independent prognostic factors (p = 0.006 and 0.013). There was no impact on survival for the other six variables. Surgical treatments in M1a NSCLC seem to be associated with improved survival than published results and might be considered in the management of selected cases. Selected patients, including good performance status and nonsmoking histology, may predict for improved survival in these patients.

Liu T ，Liu H ，Wang G ，Zhang C ，Liu B ... -  《-》

Survival of patients treated surgically for synchronous single-organ metastatic NSCLC and advanced pathologic TN stage.

Patients with stage IV metastatic non-small cell lung cancer (NSCLC) are generally not considered for surgery due to their poor median survival ranging from 4 to 11 months. However published results suggested that carefully selected patients with oligometastatic disease may benefit from resection of both the primary and metastatic sites in a multidisciplinary treatment approach. The aim of the study was to analyze and detect prognostic factors in surgically treated patients with synchronous single-organ metastasis from NSCLC. This is a retrospective single-center study including 29 patients with synchronous single-organ metastatic NSCLC who underwent lung resection and local treatment of the metastasis between 2002 and 2008. Overall survival was estimated from the date of lung surgery until last follow-up. The impact on survival of nine variables (age, pT, pN, site of metastasis, presence of solitary metastasis, R-resection status, presence of neoadjuvant or adjuvant treatment, tumor histology) were further assessed. Twenty-nine patients (20 males, 69%) with a median age of 62 (from 44 to 77) were included. Site of metastatic disease was the brain in 19, the lung in 8 and the adrenal glands in 2 patients. Histology was adenocarcinoma in 21, large-cell carcinoma in 3, squamous-cell carcinoma in 2 and other in 3 patients. Type of lung resection performed for primary tumors were pneumonectomy in 3, bilobar resection in 3, lobar resection in 17 and sublobar resection in 6 patients. Survival at 1 and 5 years for the overall population reached 65% and 36%, respectively. Median survival was 20.5 months. Univariate regression model analysis identified pathologic T stage as a predictor of survival. Patients with pT1-2 behaved statistically significantly better (p=0.007) compared to patients with pT3-4 tumors. No impact on survival for the other 8 variables has been shown. The 5-year survival rate of 36% confirms that multimodality treatment including surgical lung resection should be considered in the therapy of single-site metatastatic NSCLC for selected patients. Pathologic T stage appeared to have significant impact on predicting patient survival.

Collaud S ，Stahel R ，Inci I ，Hillinger S ，Schneiter D ，Kestenholz P ，Weder W ... -  《-》

Pleural lavage cytology before and after lung resection in non-small cell lung cancer patients.

Enatsu S ，Yoshida J ，Yokose T ，Nishimura M ，Nishiwaki Y ，Shirakusa T ，Nagai K ... -  《-》

Surgical treatment of primary lung cancer with synchronous brain metastases.

Billing PS ，Miller DL ，Allen MS ，Deschamps C ，Trastek VF ，Pairolero PC ... -  《JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY》

Prognostic impact of number of resected and involved lymph nodes at complete resection on survival in non-small cell lung cancer.

Saji H ，Tsuboi M ，Yoshida K ，Kato Y ，Nomura M ，Matsubayashi J ，Nagao T ，Kakihana M ，Usuda J ，Kajiwara N ，Ohira T ，Ikeda N ... -  《-》