Surgical Treatment in Oligometastatic Lung Cancer

Maruf Şanlı; Ahmet Uluşan; Ahmet Feridun  Işık

doi:10.5152/EurJTher.2018.1009

Authors

Maruf Şanlı Department of Thoracic Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey
Ahmet Uluşan Department of Thoracic Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey
Ahmet Feridun Işık Department of Thoracic Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey

DOI:

https://doi.org/10.5152/EurJTher.2018.1009

Keywords:

Lung cancer, oligometastasis, surgery

Abstract

Lung cancer is the primary cause of cancer-related deaths across the world. About four fifths of lung cancer patients are diagnosed with non-small cell lung cancer (NSCLC), and diagnosis can be established only at the advanced stage of disease in 70% of these patients. Among NSCLC patients, who have a maximum of five metastatic lesions which are suitable for radical therapy with local treatment (surgical resection, radiotherapy or both) to achieve long-term survival are considered to be at the oligometastatic disease stage. In this study, we examined the surgical treatment practices and their results in oligometastatic NSCLC patients. Medical literature in the thoracic surgery and oncology network was reviewed, and studies, cases, and meta-analysis studies that included surgical treatment practices in oligometastatic small cell lung cancer treatment and their results were examined. A discussion was made by also analyzing the survival data in light of the literature studies and available guidelines. The most common treatment option in oligometastatic NSCLC patients is surgical metastasectomy. The use of this method especially in patients with metastasis isolated in the contralateral lung, brain and adrenal glands has been widely accepted. For patients that are classified as M1b stage in the international guidelines, aggressive local treatment is recommended on metastatic and primary areas. If patients with multiple metastatic regions have between two to five independent metastases, then systemic chemotherapy must be applied. Long-term disease control and even improvement is possible in these patients with ablative treatment of the primary tumor and metastases.

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