Long-term Outcome of Surgery or Stereotactic Radiotherapy for Lung Oligometastases

Emily Stone, Nicole Rankin, Jane Phillips, Kwun Fong, Alistair Miller, Geraldine Largey, Robert Zielinski, Peter Flynn, David Currow, Tim Shaw

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)

Abstract

Local treatment for pulmonary oligometastases (one to five lesions) using metastasectomy or stereotactic ablative radiotherapy (SABR) was investigated in a cohort that received multidisciplinary tumor board–based treatment decisions. The first choice of treatment was surgery; SABR was recommended in cases of adverse clinical factors. Propensity score–adjusted and unadjusted overall survival was the primary end point; local control and time to failure of a local-only treatment strategy were also analyzed. With a minimum follow-up time of 5.8 years, the 5-year overall survival rate was 41% for surgery (n = 68) and 45% for SABR (n = 42). Again not different for the two modalities, 40% of patients were free from failure of a local-only treatment strategy, and 20% were free from any progression at 5 years. The 5-year local control rate was 83% for SABR and 81% for surgery. Despite treatment selection clearly disadvantaging SABR against surgery, even unadjusted outcome was not better when pulmonary oligometastases were surgically removed rather than irradiated.

Original languageEnglish
Pages (from-to)1442-1445
Number of pages4
JournalJournal of Thoracic Oncology
Volume12
Issue number9
DOIs
Publication statusPublished - 2017

Keywords

  • Lung metastases
  • Oligometastases
  • Pulmonary metastasectomy
  • Stereotactic ablative radiotherapy
  • Surgery

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