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General Thoracic and Cardiovascular... Apr 2016Non-small cell lung cancer (NSCLC) harboring a limited number of distant metastases, referred to as the oligometastatic state, has been indicated for surgery for the... (Review)
Review
Non-small cell lung cancer (NSCLC) harboring a limited number of distant metastases, referred to as the oligometastatic state, has been indicated for surgery for the past several decades. However, whether the strategy of surgical treatment results in a survival benefit for such patients remains controversial. Experientially, however, thoracic surgeons often encounter long-term survivors among surgically resected oligometastatic NSCLC patients. In this article, the current situation of surgical approach and potential future perspective for oligometastatic NSCLC are reviewed.
Topics: Adrenal Gland Neoplasms; Brain Neoplasms; Carcinoma, Non-Small-Cell Lung; Forecasting; Humans; Lung Neoplasms; Neoplasm Metastasis; Treatment Outcome
PubMed: 26895202
DOI: 10.1007/s11748-016-0630-7 -
Clinical Lung Cancer Sep 2021This review covers the importance of local consolidative therapy (LCT) in patients with epidermal growth factor receptor (EGFR) mutation-positive with oligometastatic... (Review)
Review
Management of Oligometastasis and Oligoprogression in Patients with Epidermal Growth Factor Receptor Mutation-Positive NSCLC in the Era of Third-Generation Tyrosine Kinase Inhibitors.
This review covers the importance of local consolidative therapy (LCT) in patients with epidermal growth factor receptor (EGFR) mutation-positive with oligometastatic and oligoprogressive non-small-cell lung cancer (NSCLC). With the advent of third-generation EGFR tyrosine kinase inhibitors, a more updated review is necessary. We review the efficacy of LCT, pathophysiological background, and treatment modalities other than radiotherapy. In addition, we also discussed when and how LCT should be applied to patients with oligometastatic and oligoprogressive NSCLC.
Topics: Carcinoma, Non-Small-Cell Lung; ErbB Receptors; Humans; Lung Neoplasms; Mutation; Protein Kinase Inhibitors
PubMed: 33849807
DOI: 10.1016/j.cllc.2021.03.004 -
Der Chirurg; Zeitschrift Fur Alle... Jul 2018Several case series reported results of surgical resection in patients with pancreatic ductal adenocarcinoma in a metastasized stage. (Review)
Review
BACKGROUND
Several case series reported results of surgical resection in patients with pancreatic ductal adenocarcinoma in a metastasized stage.
AIM
A summarized overview of the current state of knowledge and a summary of the results of currently available studies.
MATERIAL AND METHODS
A systematic search was carried out in MEDLINE and PubMed with respect to metastasized pancreatic cancer and surgical resection.
RESULTS
The evidence level for surgical resection in the metastasized stage is weak and so far no prospective trials are available. The largest single-arm trial included 85 patients with hepatic metastasis. In cases of hepatic oligometastasis an overall survival of 11-14 months was observed. In the presence of pulmonary metastasis, overall survival seems to be prolonged compared to intra-abdominal metastasis, although the evidence level is relatively weak.
CONCLUSION
According to the available results, a general recommendation for surgical resection in a metastasized stage cannot be given; however, the results show a possible benefit for some well-selected patient subgroups. Prospective trials must validate these data and investigate the use of combined surgical and systemic treatments in the case of resectable metastatic pancreatic cancer.
Topics: Carcinoma, Pancreatic Ductal; Hepatectomy; Humans; Neoplasm Metastasis; Pancreatectomy; Pancreatic Neoplasms; Prospective Studies
PubMed: 29557488
DOI: 10.1007/s00104-018-0626-1 -
Arquivos Brasileiros de Cirurgia... 2023Metastatic gastric cancer traditionally hinders surgical treatment options, confining them to palliative procedures. The presence of metastases in these tumors is...
Metastatic gastric cancer traditionally hinders surgical treatment options, confining them to palliative procedures. The presence of metastases in these tumors is classified as M1, irrespective of their characteristics, quantity, or location. However, oligometastatic disease emerged as an intermediate state between localized and widely disseminated cancer. It exhibits diverse patterns based on metastatic disease extent, type, and location. Adequately addressing this distinctive metastatic state necessitates tailored strategies that surpass the realm of palliative care. Differentprimary tumor types present discernible scenarios of oligometastatic disease, including preferred sites of occurrence and chronological progression. Due to the novelty of this theme and the heterogeneity of the disease, uncertainties still exist, and the ability to provide confident guidelines is challenging. Currently, there are no effective predictors to determine the response and provide clear indications for surgical interventions and systemic treatments in oligometastatic disease. Treatment decisions are commonly based on apparent disease control by systemic therapies, with a short observation period and imaging assessments. Nonetheless, the inherent risk of misinterpretation remains a constant concern. The emergence of novel technologies and therapeutic modalities, such as immunotherapy, cellular therapy, and adoptive therapies, holds the potential to reshape the landscape of surgical treatment for the oligometastatic disease in gastric cancer, expanding the surgeon's role in this multidisciplinary approach. Prospective tools for patient selection in oligometastatic gastric cancer are being explored. Using non-invasive, cost-effective, widely available imaging techniques that provide real-time information may revolutionize medical practice, ensuring precision medicine accessibility, even in resource-constrained small healthcare facilities. Incorporating molecular classifications, liquid biopsies, and radiomic analysis in a complementary protocol will augment patient selection precision for surgical intervention in oligometastasis. Hopefully, these advancements will render surgeries unnecessary in many cases by providing highly effective alternative treatments.
Topics: Humans; Stomach Neoplasms; Surgeons; Palliative Care; Patient Selection
PubMed: 37729281
DOI: 10.1590/0102-672020230034e1752 -
Japanese Journal of Clinical Oncology Dec 2023Pancreatic cancer with lung oligometastasis may have favourable overall survival. The aim of this study was to evaluate outcomes of pancreatic cancer with lung...
OBJECTIVE
Pancreatic cancer with lung oligometastasis may have favourable overall survival. The aim of this study was to evaluate outcomes of pancreatic cancer with lung oligometastases including both synchronous and metachronous metastases.
METHODS
Consecutive pancreatic cancer patients with lung metastasis treated at our institution between February 2015 and December 2021 were identified from our prospectively maintained database. Clinical characteristics and outcomes were compared and analysed according to the extent of lung metastases. Predictors for overall survival were analysed using the Cox proportional hazards model.
RESULTS
A totoal of 171 patients were included (oligometastasis/polymetastasis/multi-organ metastasis: 34/50/87). Patients with oligometastases were more likely to undergo surgical resection (41% vs. 0% vs. 2%) and showed a longer median overall survival (41.3 vs. 17.6 vs. 13.1 months) compared with those with other types of metastases. Oligometastasis (hazard ratio, 0.43; 95% confidence interval, 0.24-0.76; P = 0.004) was identified as an independent factor predicting favourable overall survival in patients with lung-only metastasis. Disease status (synchronous vs. metachronous) was not associated with survival in patients with oligometastasis (29.4 vs. 41.3 months, P = 0.527) and polymetastasis (17.9 vs. 16.7 months, P = 0.545). Selected patients who underwent surgical resection showed a median overall survival of 52.7 months.
CONCLUSIONS
Patients with lung oligometastases presented a favourable prognosis. Surgical resection in selected patients was associated with a long median overall survival.
Topics: Humans; Pancreatic Neoplasms; Lung Neoplasms; Prognosis; Proportional Hazards Models; Lung; Retrospective Studies
PubMed: 37609670
DOI: 10.1093/jjco/hyad111 -
Journal of Thoracic Disease Jan 2018
PubMed: 29600035
DOI: 10.21037/jtd.2017.12.77 -
Current Oncology Reports Jun 2024We examine the potential for curative approaches among metastatic breast cancer (MBC) patients by exploring the recent literature on local ablative therapies like... (Review)
Review
PURPOSE
We examine the potential for curative approaches among metastatic breast cancer (MBC) patients by exploring the recent literature on local ablative therapies like surgery and stereotactic body radiation therapy (SBRT) in patients with oligometastatic (OM) breast cancer. We also cover therapies for MBC patients with oligoprogressive (OP) disease.
KEY FINDINGS
Surgery and SBRT have been studied for OM and OP breast cancer, mainly in retrospective or non-randomized trials. While many studies demonstrated favorable results, a cooperative study and single-institution trial found no support for surgery/SBRT in OM and OP cases, respectively.
CONCLUSION
While there is interest in applying local therapies to OM and OP breast cancer, the current randomized data does not back the routine use of surgery or SBRT, particularly when considering the potential for treatment-related toxicities. Future research should refine patient selection through advanced imaging and possibly explore these therapies specifically in patients with hormone receptor-positive or HER2-positive disease.
Topics: Humans; Breast Neoplasms; Female; Radiosurgery; Disease Progression; Neoplasm Metastasis
PubMed: 38652425
DOI: 10.1007/s11912-024-01529-2 -
Indian Journal of Surgical Oncology Sep 2020Synchronous tumors of female genital tract have been uncommonly reported in literature. The most likely scenario would represent a metastatic disease from a primary...
Synchronous tumors of female genital tract have been uncommonly reported in literature. The most likely scenario would represent a metastatic disease from a primary tumor within the genital tract as the presence of primary synchronous tumors of the genital tract is an extremely rare event. Most primary synchronous tumors tend to involve the endometrium and ovary, while the incidence of synchronous primary tumors involving the uterine cervix and endometrium as documented in a few case series has been around 0.4%. We present a 41-year-old lady with an extremely rare occurrence of synchronous tumors of the uterus with an endometrioid adenocarcinoma of the uterine fundus and a squamous cell carcinoma of the uterine cervix. The patient presented to us with cerebral metastasis, which was successfully managed surgically.
PubMed: 33088137
DOI: 10.1007/s13193-020-01069-8 -
Der Chirurg; Zeitschrift Fur Alle... Aug 2020Most patients with pancreatic cancer suffer a relapse, which occurs either locally or systemically in the sense of liver and the lung metastases. Surgery for pancreatic... (Review)
Review
BACKGROUND
Most patients with pancreatic cancer suffer a relapse, which occurs either locally or systemically in the sense of liver and the lung metastases. Surgery for pancreatic cancer has become more radical due to the increased use of multimodal treatment concepts; however, the role of surgery in cases of recurrence remains controversial.
OBJECTIVE
This review summarizes the surgical treatment options for isolated local recurrence and metachronous oligometastatic pancreatic cancer.
MATERIAL AND METHODS
A selective literature search was carried out and the current evidence for surgical treatment is summarized.
RESULTS
There are currently no randomized studies on surgery for metastatic pancreatic cancer. Currently available data, however, show that after surgery long-term survival of up to 32-47 months after metastasectomy can be achieved, especially in patients with local recurrence or isolated pulmonary metastases with low morbidity and mortality. Individualized treatment concepts including surgical resection after initial systemic therapy seem promising even for liver metastases. The greatest survival benefits are consistently shown for all localizations in patients with a long as possible disease-free interval after the first operation.
CONCLUSION
The treatment of isolated local recurrence or metachronous oligometastatic pancreatic cancer is an interdisciplinary challenge that should be performed in specialized pancreatic treatment centers only. Surgical resection embedded in a multimodal treatment concept can be meaningful in selected cases.
Topics: Humans; Liver Neoplasms; Lung Neoplasms; Metastasectomy; Neoplasm Recurrence, Local; Pancreatic Neoplasms
PubMed: 32424598
DOI: 10.1007/s00104-020-01190-y -
International Journal of Radiation... Nov 2022
Topics: Breast Neoplasms; Female; Humans; Lung Neoplasms; Neoplasm Recurrence, Local; Receptors, Estrogen
PubMed: 36244388
DOI: 10.1016/j.ijrobp.2022.02.029