Surgical Treatment in Oligometastatic Lung Cancer

Abstract

Lung cancer is the primary cause of cancer-related deaths across the world. About four fifths of lung cancer patients are diagnosedwith non-small cell lung cancer (NSCLC), and diagnosis can be established only at the advanced stage of disease in 70% of thesepatients. Among NSCLC patients, who have a maximum of five metastatic lesions which are suitable for radical therapy with localtreatment (surgical resection, radiotherapy or both) to achieve long-term survival are considered to be at the oligometastatic diseasestage. In this study, we examined the surgical treatment practices and their results in oligometastatic NSCLC patients. Medical literaturein the thoracic surgery and oncology network was reviewed, and studies, cases, and meta-analysis studies that included surgicaltreatment practices in oligometastatic small cell lung cancer treatment and their results were examined. A discussion was made byalso analyzing the survival data in light of the literature studies and available guidelines. The most common treatment option inoligometastatic NSCLC patients is surgical metastasectomy. The use of this method especially in patients with metastasis isolated inthe contralateral lung, brain and adrenal glands has been widely accepted. For patients that are classified as M1b stage in the internationalguidelines, aggressive local treatment is recommended on metastatic and primary areas. If patients with multiple metastaticregions have between two to five independent metastases, then systemic chemotherapy must be applied. Long-term disease controland even improvement is possible in these patients with ablative treatment of the primary tumor and metastases.