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Clinical outcome of node‐negative oligometastatic non–small cell lung cancer

机译:淋巴结阴性转移性非小细胞肺癌的临床结果

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IntroductionThe concept of “oligometastasis” has emerged as a basis on which to identify patients with stage IV non–small cell lung cancer (NSCLC) who might be most amenable to curative treatment. Limited data have been available regarding the survival of patients with node-negative oligometastatic NSCLC. Patients and methodsConsecutive patients with advanced NSCLC who attended Kindai University Hospital between January 2007 and January 2016 were recruited to this retrospective study. Patients with regional lymph node–negative disease and a limited number of metastatic lesions (≤5) per organ site and a limited number of affected organ sites (1 or 2) were eligible. ResultsEighteen patients were identified for analysis during the study period. The most frequent metastatic site was the central nervous system (CNS, 72%). Most patients (83%) received systemic chemotherapy, with only three (17%) undergoing surgery, for the primary lung tumor. The CNS failure sites for patients with CNS metastases were located outside of the surgery or radiosurgery field. The median overall survival for all patients was 15.9?months, with that for EGFR mutation–positive patients tending to be longer than that for EGFR mutation–negative patients. ConclusionCure is difficult to achieve with current treatment strategies for NSCLC patients with synchronous oligometastases, although a few long-term survivors and a smaller number of patients alive at last follow-up were present among the study cohort. There is an urgent clinical need for prospective evaluation of surgical resection as a treatment for oligometastatic NSCLC, especially negative for driver mutations.
机译:引言“低转移”的概念已成为确定最适合治疗的IV期非小细胞肺癌(NSCLC)患者的基础。关于淋巴结阴性少转移性NSCLC患者的生存率方面的数据有限。患者和方法2007年1月至2016年1月间在金台大学医院就诊的连续性晚期NSCLC患者被纳入该回顾性研究。患有区域淋巴结阴性疾病且每个器官部位的转移灶数目有限(≤5)且受影响器官部位的数目有限(1或2)的患者是合格的。结果在研究期间确定了18例患者进行分析。最常见的转移部位是中枢神经系统(CNS,72%)。大多数患者(83%)因原发性肺肿瘤接受了全身化疗,只有三例(17%)接受了手术。中枢神经系统转移患者的中枢神经系统衰竭部位位于手术或放射外科手术领域之外。所有患者的中位总生存期为15.9月,EGFR突变阳性患者的中位生存期往往比EGFR突变阴性患者的中位生存期更长。结论尽管目前队列研究中存在少数长期幸存者和最后一次随访还活着的患者较少,但目前的治疗策略很难使具有同步性低转移的NSCLC患者治愈。迫切需要对外科手术切除进行前瞻性评估,以作为对转移性NSCLC的治疗,特别是对于驾驶员突变阴性的临床需求。

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