title: Survival outcomes for oligometastasis in resected non-small cell lung cancer.
abstract: BACKGROUND
  We investigated the factors associated with post-recurrence survival and the treatment for non-small-cell lung cancer patients with postoperative distant recurrence, especially oligometastasis.
  
  
  METHODS
  We reviewed the data of 272 patients with distant recurrence who underwent resection of non-small-cell lung cancer from January 2000 through December 2011.
  
  
  RESULTS
  The type of distant recurrence was classified as oligometastasis (n = 76, 28%) or polymetastasis (n = 196, 72%). Forty-seven (62%) patients with oligometastasis received local therapy (surgery 5, radiotherapy 9, sequential local and systemic therapy 28, chemoradiotherapy 5). Multivariate analysis revealed older age, non-adenocarcinoma, shorter disease-free interval, no pulmonary metastasis, liver metastases, bone metastases, and polymetastasis had significant associations with unfavorable post-recurrence survival. Subgroup analysis of patients with oligometastasis showed histology and disease-free interval had a great impact on survival. Smoking history and histology were associated with survival in patients with lung oligometastasis, whereas systemic treatment and longer disease-free interval were related to increased post-recurrence survival in those with brain oligometastasis.
  
  
  CONCLUSIONS
  This study showed that an oligometastatic state per se was a significant favorable factor. Optimization of personalized systemic treatment and adding local treatment are important in the management of patients with non-small-cell lung cancer and oligometastasis.
authors.affiliation: Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan zenkyu@za3.so-net.ne.jp.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Shimada
authors.affiliation: Department of Chest Surgery, St. Marianna University School of Medicine, Tokyo, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Saji
authors.affiliation: Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kakihana
authors.affiliation: Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Kajiwara
authors.affiliation: Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ohira
authors.affiliation: Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
keywords: Carcinoma; Disease-free survival; Neoplasm recurrence; Recurrence; Survival; local; non-small-cell lung