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Ann Thorac Surg 2007;83:231-234
© 2007 The Society of Thoracic Surgeons

Original Articles: General Thoracic

Oligometastatic Non–Small Cell Lung Cancer: A Multidisciplinary Approach in the Positron Emission Tomographic Scan Era

Tommaso M. De Pas, MDa,*, Filippo de Braud, MDa, Gianpiero Catalano, MDb, Carlo Putzu, MDa, Giulia Veronesi, MDc, Francesco Leo, MDc, Piero G. Solli, MDc, Daniela Brambilla, PhDc, Giovanni Paganelli, MDd, Lorenzo Spaggiari, MD, PhDc,e

a New Drugs Development Unit, Department of Medicine, European Institute of Oncology, Milan, Italy
b Radiation Therapy Division, European Institute of Oncology, Milan, Italy
c Thoracic Surgery Division, European Institute of Oncology, Milan, Italy
d Nuclear Medicine Division, European Institute of Oncology, Milan, Italy
e University of Milan, School of Medicine, Milan, Italy

Accepted for publication August 8, 2006.

* Address correspondence to Dr De Pas, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy (Email: tommaso.de-pas{at}ieo.it).

BACKGROUND: We have assessed the survival rate of patients with non–small cell lung cancer and synchronous hematogenous solitary metastasis identified with complete staging workup, including total body [18F]fluorodeoxyglucose positron emission tomography scan, and treated with a multidisciplinary approach.

METHODS: We examined the database of all patients who underwent surgery for primary non–small cell lung cancer in our institute. The criteria required for inclusion in this analysis were diagnosis of non–small cell lung cancer with synchronous hematogenous solitary metastasis by staging workup with total body computed tomography scan and brain magnetic resonance if indicated, total body positron emission tomography scan, radical surgery for the primary tumors, local treatment of the solitary metastasis, and systemic chemotherapy administration.

RESULTS: We analyzed the data from 1,509 patients treated from January 2000 to December 2005: 10 patients (0.7%) satisfied the selection criteria. The median overall survival was 26 months, and the median time to progression was 20 months; 6 patients were alive at the time of analysis, with a median follow-up of 30 months. Four patients were tumor progression–free after 9, 18, 23, and 32 months from the start of their treatment.

CONCLUSIONS: The presentation of non–small cell lung cancer with a synchronous hematogenous solitary metastasis identified by [18F]fluorodeoxyglucose positron emission tomography containing complete staging workup is extremely rare. This subset of patients can achieve long-term survival after a multidisciplinary treatment approach.


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Invited commentary
Joachim Pfannschmidt
Ann. Thorac. Surg. 2007 83: 234-235. [Extract] [Full Text] [PDF]





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