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Journal of Thoracic Disease Apr 2017
PubMed: 28523182
DOI: 10.21037/jtd.2017.04.06 -
Gan To Kagaku Ryoho. Cancer &... Oct 2017Lung cancer with a few to several metastases is so-called oligometastatic disease. Patient with recurrence only to limited site is also known as oligo-recurrence, and...
Lung cancer with a few to several metastases is so-called oligometastatic disease. Patient with recurrence only to limited site is also known as oligo-recurrence, and may be included as oligometastatic disease. From biological aspect, any existence of metastases is a sign of systemic disease. Due to the reports of long survival with only local treatment and without systemic disease in oligometastatic lung cancer, word of oligometastasis is used with fascinating expectation of cure to advanced lung cancer. Most of the previous reports are retrospective and no comprehensive data exists for selecting patient for local treatment to oligometastasis. Recent positive result of randomize phase II study is followed up with phase III study. Progress in treatment of advanced non-small cell lung cancer with targeted therapy to oncogenic-driver(EGFR, ALK, ROS1 and others) and immune-checkpoint inhibitor(PD-1 pathway inhibitors)makes it difficult to define the appropriate indication of local treatment to oligometastatic lung cancer.
Topics: Disease Progression; Humans; Lung Neoplasms; Molecular Targeted Therapy; Neoplasm Metastasis; Practice Guidelines as Topic; Prognosis
PubMed: 29066671
DOI: No ID Found -
Klinicka Onkologie : Casopis Ceske a... 2022Benign lymphoid hyperplasia (BLH) is a rare lymphoproliferative disorder of normal polyclonal B lymphocytes, but is sometimes difficult to distinguish from malignancy.
BACKGROUND
Benign lymphoid hyperplasia (BLH) is a rare lymphoproliferative disorder of normal polyclonal B lymphocytes, but is sometimes difficult to distinguish from malignancy.
CASE
An 87-year-old man with a history of localized non-small cell lung cancer (NSCLC) was referred for evaluation and treatment of an elastic hard tumor in the left supraclavicular fossa one year after stereotactic ablative radiotherapy (SABR). Whole-body PET scan showed high 18F-fluorodeoxyglucose uptake in the left supraclavicular fossa, and a dia-gnosis of oligometastasis was made. The tumor was homogeneously high signal on T2-weighted image with homogeneous enhancement after contrast administration. Since the palpation and MRI findings were inconsistent with those of metastatic NSCLC, a bio-psy was performed. Pathological and immunohistochemical investigation revealed the lesion to be BLH.
CONCLUSION
In a patient with suspected oligometastasis after SABR for NSCLC, caution should be exercised before undergoing SABR for oligometastasis because BLH may be present.
Topics: Male; Humans; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Hyperplasia; Radiosurgery; Fluorodeoxyglucose F18
PubMed: 36513515
DOI: 10.48095/ccko2022482 -
Thoracic Cancer Jul 2022Highly active and durable systemic therapies such as targeted therapy and immunotherapy can convert widespread metastatic disease into oligometastatic status, for which...
Highly active and durable systemic therapies such as targeted therapy and immunotherapy can convert widespread metastatic disease into oligometastatic status, for which metastasis-directed local intervention can control and potentially prolong survival. Radiation therapy is an effective therapeutic option for oligometastatic and oligoprogressive disease. Here, we present a case of induced oligometastasis and repeated oligoprogressive lung cancer in which more than 6 years of survival was achieved with a combination of immunotherapy and radiotherapy.
Topics: Adenocarcinoma of Lung; Humans; Immunotherapy; Lung Neoplasms; Radiosurgery
PubMed: 35599247
DOI: 10.1111/1759-7714.14479 -
Nature Reviews. Clinical Oncology Jun 2011We previously proposed a clinical state of metastasis termed 'oligometastases' that refers to restricted tumor metastatic capacity. The implication of this concept is... (Review)
Review
We previously proposed a clinical state of metastasis termed 'oligometastases' that refers to restricted tumor metastatic capacity. The implication of this concept is that local cancer treatments are curative in a proportion of patients with metastases. Here we review clinical and laboratory data that support the hypothesis that oligometastasis is a distinct clinical entity. Investigations of the prevalence, mechanism of occurrence, and position in the metastatic cascade, as well as the determination of molecular markers to distinguish oligometastatic from polymetastatic disease, are ongoing.
Topics: Humans; Neoplasm Metastasis; Neoplasms
PubMed: 21423255
DOI: 10.1038/nrclinonc.2011.44 -
Cureus May 2023A 74-year-old male was diagnosed with right hilar T4N1M0 squamous cell carcinoma of the lung. Radical oncological treatment was initiated with curative intent. Despite...
A 74-year-old male was diagnosed with right hilar T4N1M0 squamous cell carcinoma of the lung. Radical oncological treatment was initiated with curative intent. Despite this, a post-operative computed tomography scan showed residual disease. Therefore, right thoracotomy and salvage pneumonectomy were performed. The patient recovered well post-operatively. Unfortunately, seven months later, he re-presented with a left scapula subcutaneous mass, with a biopsy confirming metastatic lung squamous cell carcinoma. Radiotherapy was not possible as it would have irradiated the remaining lung, and therefore, surgical resection and chest wall reconstruction were undertaken. The patient remains free of disease at 6 months follow-up. We present an interesting case of surgical management of oligometastatic lung cancer.
PubMed: 37398810
DOI: 10.7759/cureus.39790 -
Annals of Gastroenterological Surgery Jan 2024While surgery is essential for curative treatment of gastric cancer with oligometastasis, its target, timing, and possibility of combination with other treatments are...
AIM
While surgery is essential for curative treatment of gastric cancer with oligometastasis, its target, timing, and possibility of combination with other treatments are unclear. We herein investigated the clinical course and long-term outcomes of gastric cancer with oligometastasis in the real world setting to determine the optimal therapeutic strategy.
METHODS
The present study retrospectively analyzed 992 patients who received any treatment for metastatic or recurrent gastric adenocarcinoma at Tokyo Metropolitan Komagome Hospital between 2007 and 2019. Oligometastasis was defined as any one of the following: liver metastases (HEP) <3; lung metastases (PUL) <3; unilateral adrenal gland metastasis (ADR); para-aortic lymph node metastasis (PALN); or one, distant, lymph node metastasis, excluding the regional lymph nodes (LYM). Overall survival was compared by the characteristics and treatments for the oligometastasis, and univariate and multivariate analyses were used to identify the prognostic factors of overall survival.
RESULTS
Ninety-seven patients (9.8%) with the following metastasis sites were enrolled: HEP ( = 27), PUL ( = 2), ADR ( = 3), PALN ( = 55), and LYM ( = 10). The median survival time of the cohort was 22.8 months, and the five-year overall survival rate was 28.4%. On multivariate analysis, chemotherapy for the initial treatment (hazard ratio [HR]: 0.438; = 0.048), distal gastrectomy and/or metastasectomy (HR: 0.290; = 0.001), and R0 resection (HR: 0.373; = 0.005) were identified as independent, positive factors of overall survival.
CONCLUSION
The long-term outcomes of gastric cancer in patients with oligometastasis may improve if treatment is begun with chemotherapy rather than surgery.
PubMed: 38250694
DOI: 10.1002/ags3.12733 -
Reports of Practical Oncology and... 2022About 60-90% of cancer patients are estimated to develop bone metastases, particularly in the spine. Bone scintigraphy, computed tomography (CT ) and magnetic resonance... (Review)
Review
About 60-90% of cancer patients are estimated to develop bone metastases, particularly in the spine. Bone scintigraphy, computed tomography (CT ) and magnetic resonance imaging (MRI ) are currently used to assess metastatic bone disease; positron emission tomography/computed tomography (PET-CT ) has become more widespread in clinical practice because of its high sensitivity and specificity with about 95% diagnostic accuracy. The most common and well-known radiotracer is 18F-fluorodeoxyglucose (FDG); several other PET-radiotracers are currently under investigation for different solid tumors, such as C or FDG-choline and prostate specific membrane antigen (PSMA)-PET/CT for prostate cancer. In treatment planning, standard and investigational imaging modalities should be registered with the planning CT so as to best define the bone target volume. For target volume delineation of spine metastases, the International Spine Radiosurgery Consortium (ISRC ) of North American experts provided consensus guidelines. Single fraction stereotactic radiotherapy (SRT ) doses ranged from 12 to 24 Gy; fractionated SRT administered 21-27 Gy in 3 fractions or 20-35 Gy in 5 fractions. After spine SRT, less than 5% of patients experienced grade ≥ 3 acute toxicity. Late toxicity included the extremely rare radiation-induced myelopathy and a 14% risk of de novo vertebral compression fractures.
PubMed: 35402030
DOI: 10.5603/RPOR.a2022.0009 -
Urology Annals 2022Right ventricular (RV) metastasis from an upper tract urothelial carcinoma without inferior vena cava or right atrial involvement is an extremely rare event which...
Right ventricular (RV) metastasis from an upper tract urothelial carcinoma without inferior vena cava or right atrial involvement is an extremely rare event which highlights the heterogeneity of this disease process. We report a case of a 43-year-old man presenting for long-standing hematuria and left flank pain. Computed tomography revealed a left renal mass with para-aortic lymphadenopathy, in addition to a potential mass in the RV. The mass involving the RV was confirmed on subsequent cardiac evaluation with magnetic resonance imaging (MRI) and echocardiography. After discussion in a multidisciplinary tumor board, the patient underwent a left nephrectomy, regional lymphadenectomy, and excision of metastatic RV tumor with bovine patch reconstruction. Final pathology reported invasive urothelial carcinoma in the left kidney with involvement of regional para-aortic lymph nodes and metastatic tumor in the RV (T4N3M1, AJCC 8 edition). The patient did well postoperatively and completed adjuvant Cisplatin-Gemcitabine systemic chemotherapy. This is an important addition to the literature as it highlights the aggressive and heterogeneous nature of urothelial carcinoma and the utility of cardiac MRI in surgical planning.
PubMed: 35197710
DOI: 10.4103/UA.UA_157_20 -
Journal of Radiosurgery and SBRT 2019The use of SRS/SBRT has been extensively reported on for tumors of the lung, liver, pancreas, adrenal gland, brain, and spine. Tumor control and associated toxicities of...
The use of SRS/SBRT has been extensively reported on for tumors of the lung, liver, pancreas, adrenal gland, brain, and spine. Tumor control and associated toxicities of treatment are well understood and the use of SBRT in these sites is well-accepted. Here we uniquely report a detailed case of SBRT to the spleen and demonstrate pre- and post-treatment imaging along with treatment planning implications. We demonstrate excellent local control at 4 year follow-up with no development of late toxicity.
PubMed: 31641552
DOI: No ID Found