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Cancer Research and Treatment Oct 2022We intend to investigate the oncological efficacy and feasibility of local consolidative therapy (LCT) through a meta-analysis method. (Meta-Analysis)
Meta-Analysis
PURPOSE
We intend to investigate the oncological efficacy and feasibility of local consolidative therapy (LCT) through a meta-analysis method.
MATERIALS AND METHODS
Four databases including PubMed, MEDLINE, Embase, and Cochrane library were searched. Target studies are controlled trials comparing outcomes of LCT versus a control group. Primary endpoints are overall survival (OS) and progression-free survival (PFS).
RESULTS
A total of 54 studies involving 7,242 patients were included. Pooled analyses showed that the LCT arm could achieve improved OS with pooled odds ratio of 2.896 (95% confidence interval [CI], 2.377 to 3.528; p < 0.001). Regarding PFS, pooled analyses showed pooled odds ratio of 3.045 (95% CI, 2.356 to 3.937; p < 0.001) in favor of the LCT arm. In the subgroup analyses including the studies with reliable comparability (e.g. randomized studies or intentionally matched studies without significant favorable prognosticator in LCT arms), pooled odds ratio was 2.548 (95% CI, 1.808 to 3.591; p < 0.001) favoring the LCT arm regarding OS. Regarding PFS, pooled OR was 2.656 (95% CI, 1.713 to 4.120; p < 0.001) which also favored the LCT arm. Subgroup analyses limited to the randomized controlled trials (RCT) were also performed and pooled odds ratios on OS and PFS were 1.535 (95% CI, 1.082 to 2.177; p=0.016) and 1.668 (95% CI, 1.187 to 2.344; p=0.003). The rates of grade ≥ 3 complications related to LCT was mostly low (< 10%) and not significantly higher compared to the control arm.
CONCLUSION
Pooled analyses results of all included studies, selected studies with reliable comparability, and RCT's demonstrated the survival benefit of LCT. These consistent results suggest that LCT was beneficial to the patients with oligometastasis.
Topics: Humans; Lymphoma, Follicular; Progression-Free Survival
PubMed: 35989655
DOI: 10.4143/crt.2022.329 -
Mathematical Biosciences May 2014Oligometastasis can be defined as a state of limited metastases that is potentially amenable to ablative local therapy; the success of such therapy depends on whether or...
Oligometastasis can be defined as a state of limited metastases that is potentially amenable to ablative local therapy; the success of such therapy depends on whether or not additional occult metastases exist. A model is presented here to predict occult metastases given detectable oligometastases. Predictions were based on Bayes' theorem, in conjunction with descriptions of the statistical distributions for the sizes and numbers of hematogenous metastases. The background probability for occult metastases in individuals with oligometastases increased markedly with relatively minor increases in metastatic potential. With each additional metastasis detected the chance of further occult metastases increased. These latter increases were incremental and proportionately smaller with the more metastatic tumors. Long disease free intervals had a major effect to decrease in the probability of further occult disease. Demonstration of oligometastases depends heavily upon the sensitivity of radiological imaging techniques, where the proportion of detectable metastases relates to the position of the distribution of metastasis growth times with respect to the detection threshold. Given the limitations of radiological methods, and the possibility that the oligometastases detected may be the only disease, an aggressive approach appears indicated.
Topics: Animals; Bayes Theorem; Female; Humans; Male; Mathematical Concepts; Melanoma, Experimental; Mice; Models, Biological; Models, Statistical; Neoplasm Metastasis; Neoplasms, Unknown Primary
PubMed: 24560886
DOI: 10.1016/j.mbs.2014.02.006 -
World Journal of Nuclear Medicine 2021Accurate staging and restaging with early detection of recurrent site is the key for planning treatment in patients of prostate cancer. Recently, gallium-68...
Accurate staging and restaging with early detection of recurrent site is the key for planning treatment in patients of prostate cancer. Recently, gallium-68 prostate-specific membrane antigen positron-emission tomography computed tomography (Ga-PSMA PET/CT) has emerged as a better tool for this. Few uncommon sites of early metastasis can also be identified in addition to the other common sites. Herein, we present three cases of early metastasis to testis in prostate cancer identified on Ga-PSMA PET/CT scan.
PubMed: 33850501
DOI: 10.4103/wjnm.WJNM_39_20 -
In Vivo (Athens, Greece) 2020A retrospective study was conducted to evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for pulmonary oligometastasis from colorectal cancer...
BACKGROUND/AIM
A retrospective study was conducted to evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for pulmonary oligometastasis from colorectal cancer (CRC).
PATIENTS AND METHODS
Patients with pulmonary oligometastasis from CRC who were treated with SBRT between April 2010 and October 2018 were enrolled in this study. All patients underwent SBRT using Cyberknife® with a dose of 54-60 Gy in 3 fractions to 99% of the clinical target volume. The treatment efficacy was evaluated by the local control (LC) and overall survival (OS) rates. The toxicity was evaluated using the National Cancer Institute's Common Terminology Criteria for Adverse Events version 4.0.
RESULTS
Twenty-six lesions in 20 patients were treated with SBRT. The median follow-up duration was 19 months (range=6-98 months). Local recurrence occurred in 6 of 26 lesions with a median follow-up of 12 months. The 2-year LC and OS rates were 65.8% and 88.6%, respectively. No patient developed ≥ grade 2 toxicity in the lung and other sites.
CONCLUSION
Although very high doses were delivered to the tumors with SBRT, the LC of pulmonary metastasis from CRC was not satisfactory when compared to that for stage I primary non-small cell lung cancer reported in the literature.
Topics: Carcinoma, Non-Small-Cell Lung; Colorectal Neoplasms; Humans; Lung; Lung Neoplasms; Neoplasm Recurrence, Local; Radiosurgery; Retrospective Studies; Treatment Outcome
PubMed: 32871842
DOI: 10.21873/invivo.12130 -
Oncotarget Dec 2017We investigated whether the concept of oligometastasis may be introduced to the clinical management of metastatic bladder cancer patients. Our study population comprised...
We investigated whether the concept of oligometastasis may be introduced to the clinical management of metastatic bladder cancer patients. Our study population comprised 128 patients diagnosed with metastatic bladder cancer after total cystectomy at our 6 institutions between 2004 and 2014. We extracted independent predictors for identifying a favorable. Occurrence that fulfilled all 4 criteria which were independently associated with cancer-specific death was defined as oligometastasis: a solitary metastatic organ; number of metastatic lesions of 3 or less; the largest diameter of metastatic foci of 5cm or less; and no liver metastasis. We evaluated differences in clinical outcomes between patients with oligometastasis (oligometastasis group) and those without oligometastasis (non-oligometastasis group). Overall, there were 43 patients in the oligometastasis group. The 2-year cancer-specific survival rate in the oligometastasis group was 53.3%, which was significantly higher than that in the non-oligometastasis group (16.1%, p<0.001). A multivariate analysis revealed that non-oligometastasis (p<0.001), not performing salvage chemotherapy (p<0.001), and not performing metastatectomy (p=0.028) were independent risk factors for cancer-specific death. In the subgroup of 83 patients who received salvage chemotherapy, 30 were in the oligometastasis group. The 2-year cancer-specific survival rate in the oligometastasis group was 55.0%, which was significantly higher than that in the non-oligometastasis group (22.0%, p=0.005). Non-oligometastasis (p=0.009) was the only independent risk factor for cancer-specific death. We presented that urothelial carcinoma with oligometastasis had a favorable prognosis and responded to systemic chemotherapy. Oligometastasis may be treated as a separate entity in the field of metastatic urothelial carcinoma.
PubMed: 29340094
DOI: 10.18632/oncotarget.22911 -
Radiotherapy and Oncology : Journal of... Jan 2021This study aimed to evaluate the efficacy of radical radiotherapy and assess prognostic factors in metachronous oligometastatic esophageal cancer (MOEC) patients after...
BACKGROUND AND PURPOSE
This study aimed to evaluate the efficacy of radical radiotherapy and assess prognostic factors in metachronous oligometastatic esophageal cancer (MOEC) patients after initial treatment with curative-intent surgery and/or chemoradiotherapy.
MATERIALS AND METHODS
MOEC Patients during 2009-2018 in Mianyang Central Hospital were retrospectively analyzed. Each patient had ≤5 oligometastatic lesions, and the primary lesions were controlled in this study. Patients were devided into radiotherapy (RT) and non-radiotherapy (NRT) groups. The study endpoints were overall survival (OS) and treatment toxicities.
RESULTS
This study included 82 patients who underwent intensity-modulated radiotherapy for MOEC. Median OS were 14 (95% confidence interval [CI], 11.0-17.0) and 7 (95% CI, 4.5-9.5) months for the RT and NRT groups, respectively (P = 0.016). Median OS were 18 (95% CI, 13.6-22.4) and 10 (95% CI, 5.1-14.9) months for lung and bone metastases, respectively (P = 0.010). Median OS were 15 (95% CI, 12.4-17.6) and 10 (95% CI, 7.6-12.4) months for interval time from initial diagnosis to metastasis ≥12 and <12 months, respectively (P = 0.026). Median OS were 16 (95% CI, 12.2-19.8) and 10 (95% CI, 5.0-15.0) months for biological effective dose (BED) ≥ 60 Gy and BED < 60 Gy, respectively (P = 0.033). Cox multivariate regression analysis showed that treatment modality (RT vs. NRT) was an independent prognostic factor for MOEC patients (hazard ratio: 1.8, 95% CI: 1.1-3.0; P = 0.022). No toxic side effects greater than grade 3 were observed in all patients.
CONCLUSIONS
Radiotherapy is a feasible and positive treatment for MOEC patients after initial treatment, a radical radiation dose with BED ≥ 60 Gy has benefits in extending survival. Radical radiotherapy should thus be considered for MOEC patients.
Topics: Chemoradiotherapy; Esophageal Neoplasms; Humans; Lung Neoplasms; Radiosurgery; Radiotherapy, Intensity-Modulated; Retrospective Studies; Treatment Outcome
PubMed: 32980382
DOI: 10.1016/j.radonc.2020.09.042 -
Neoplasia (New York, N.Y.) May 2022The utility of radiotherapy as a means of palliating symptoms due to metastatic cancer is well-accepted. A growing body of literature suggests that radiotherapy may play...
The utility of radiotherapy as a means of palliating symptoms due to metastatic cancer is well-accepted. A growing body of literature suggests that radiotherapy may play a role beyond palliation in some patients with low-burden metastatic disease. Recent data suggest that oligometastasis-directed radiotherapy may improve progression-free and even overall survival in select patients. Immunotherapy also has a growing role in the management of patients with metastatic cancer and, like radiotherapy, appears to be most effective in the setting of low-volume disease. Thus, the addition of immunotherapy may be a feasible means of increasing the therapeutic ratio of metastasis-directed radiotherapy, particularly among patients with oligometastatic cancer.
Topics: Humans; Immunotherapy; Neoplasms
PubMed: 35303578
DOI: 10.1016/j.neo.2022.100782 -
Journal of Thoracic Disease May 2019
PubMed: 31245149
DOI: 10.21037/jtd.2019.02.94 -
Anticancer Research Aug 2021Oligometastatic cancer (OM) is possibly associated with relatively better survival outcomes. We attempted to identify cases in line with this OM concept.
BACKGROUND
Oligometastatic cancer (OM) is possibly associated with relatively better survival outcomes. We attempted to identify cases in line with this OM concept.
PATIENTS AND METHODS
A total of 130 cases with unresectable metastatic pancreatic cancer underwent non-curative surgery from April 2001 to December 2019. Sites of metastasis, clinicopathological information, and surgical outcomes were collected to formulate a better definition of OM.
RESULTS
OM criteria were defined as having metastasis to a single organ, few countable lesions and low serum cancer antigen 19-9 level. The median overall survival after non-curative surgery of OM cases was 13.0 months and was significantly better than that of non-OM cases (8.4 months, p=0.003).
CONCLUSION
We propose single-organ metastasis of limited tumor volume (H1 or P1/2 by the Japanese Society of Cancer of the Colon and Rectum classification) and low serum cancer antigen 19-9 level (<2,000 U/ml) as new criteria for defining OM pancreatic cancer.
Topics: Aged; CA-19-9 Antigen; Carcinoma, Pancreatic Ductal; Female; Humans; Liver Neoplasms; Lung Neoplasms; Male; Pancreatic Neoplasms; Peritoneal Neoplasms; Tumor Burden
PubMed: 34281856
DOI: 10.21873/anticanres.15189 -
Anticancer Research Nov 2023This study aimed to evaluate the outcomes of patients who underwent resection for oligometastasis from hepatocellular carcinoma (HCC) and identify the prognostic factors...
BACKGROUND/AIM
This study aimed to evaluate the outcomes of patients who underwent resection for oligometastasis from hepatocellular carcinoma (HCC) and identify the prognostic factors associated with poor survival.
PATIENTS AND METHODS
Patients who underwent resection for oligometastasis from HCC between January 2000 and April 2021 were retrospectively investigated. Oligometastasis was defined as 1-5 single organ metastases that were detected preoperatively in this study. Clinical characteristics and treatment outcomes were analyzed, and independent risk factors for poor prognosis were identified using cox proportional hazards model.
RESULTS
A total of 33 patients were included in this study. Eleven oligometastases were located in the intraabdominal lymph node, 8 in the adrenal gland, 5 in the lung, 4 in the peritoneum, 3 in the pleura, and 1 each in the supraclavicular lymph node and abdominal wall. No re-operation or operative death occurred in this study. The median OS was 44.6 months (range=5.1-150.6 months), and the median survival after primary HCC diagnosis was 116.5 months (range=7.1-253.6 months). The median cumulative incidence of recurrent HCC was 7.2 months (range=0.3-94.7 months). The multivariate analysis showed that an alpha-fetoprotein level ≥20 ng/ml and multiple primary HCC tumors were independent poor prognostic factors.
CONCLUSION
Clinical characteristics and treatment outcomes of patients who underwent resection for oligometastasis from HCC were demonstrated. A high alpha-fetoprotein level and multiple primary HCC tumors were independent poor prognostic factors. Surgical resection can be one of the treatment options for oligometastasis from HCC.
Topics: Humans; Prognosis; Carcinoma, Hepatocellular; Retrospective Studies; alpha-Fetoproteins; Liver Neoplasms; Neoplasms, Multiple Primary
PubMed: 37909959
DOI: 10.21873/anticanres.16720