Perspectives in Surgery of Oligometastatic Non-Small-Cell Lung Cancer

*Fabio Villa, Barberá Carbonell Beatriz, Stefano Cafarotti

Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
*Correspondence to fabiovilla210486@gmail.com

Disclosure: No potential conflict of interest.
Received: 08.10.14 Accepted: 26.01.15
Citation: EMJ Oncol. 2015;3[1]:29-33.

Abstract

20-50% of patients with newly diagnosed non-small-cell lung cancer (NSCLC) have synchronous metastases. This dramatically affects survival and traditionally excludes patients from the spectrum of curative therapies. Nonetheless, studies have been performed to assess the role of surgery in Stage 4 NSCLC with metastases circumscribed to a single or limited number of organs, proposing the definition of oligometastatic NSCLC to enlarge the possibility of curative resection. Aggressive treatments have shown promising results; however, the great heterogeneity of survival outcomes implies the bias of  selection of patients who can benefit from surgery. The new molecular-targeted systemic therapies, cytotoxic regimens, and radiant treatments can complement surgery in metastatic NSCLC, leading to  optimal control of the disease. Retrospective series can help us to design prospective trials, selecting  patients with positive prognostic determinants to undergo intensive resective and pharmacologic  treatments. Molecular and gene profiling will probably be the most accurate method to elect candidates to sanative therapy in Stage 4 NSCLC.

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