title: Results of a surgical resection for patients with stage IV non--small-cell lung cancer.
abstract: OBJECTIVE
  This study retrospectively investigated the clinical significance of surgical treatment for stage IV non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  There were 36 patients who underwent surgical resection for stage IV NSCLC between 1999 and 2008.
  
  
  RESULTS
  The patients included 22 males and 14 females. All patients had either synchronous distant metastasis or pleural dissemination. The mean age of the patients was 65.8 years (range, 18 to 90 years). The histological types included 29 adenocarcinomas, 5 squamous-cell carcinomas and 2 large-cell carcinomas. The organs of metastasis were bone in 5 patients, brain in 4, adrenal gland in 4, axillary lymph nodes in 3, liver in 2, and 1 patient had a contralateral pulmonary metastasis. The number of metastases was one site in 13, two sites in 3, three sites in 1, and five sites in 2 patients. The patients with bone metastasis were treated with radiation, and the patients with brain metastasis underwent stereotaxic radiosurgery. The patients with either adrenal metastasis, axillary lymph node metastasis, or contralateral lung metastasis underwent surgical resection. Among the patients with distant metastasis, the 5-year survival rate was 30.1 %. There were 17 patients with pleural dissemination. The 5-year survival rate in these patients was 25.3%. The overall 5-year survival rate after surgery in the patients with stage IV disease was 26.8%.
  
  
  CONCLUSIONS
  Selected patients who can undergo surgical resection for the primary tumor and effective local therapy for metastatic lesions still have a chance to obtain long-term survival. Surgical treatment for NSCLC with oligometastatic disease can be considered as one arm of multidisciplinary treatment.
authors.affiliation: Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hanagiri
authors.forename: Masaru
authors.initials: M
authors.lastname: Takenaka
authors.forename: Soich
authors.initials: S
authors.lastname: Oka
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Shigematsu
authors.forename: Yoshika
authors.initials: Y
authors.lastname: Nagata
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Shimokawa
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Uramoto
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D016634:Radiosurgery; D011878:Radiotherapy; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult