The special status of stage <b>Ⅳ</b> non-small cell lung cancer that need surgical attention—The resection of "oligo-progression" in long-term survivors after effective systemic treatment_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 CHENG Keneng

Department of Thoracic Surgery, Beijing Cancer Hospital, Peking University, Beijing, 100142, P.R.China;

Corresponding author：

CHENG Keneng, Email: chenkeneng@bjmu.edu.cn

Keywords：

StageⅣnon-small cell lung cancer; long-term survivor; oligometastasis; surgical intervention

DOI：

10.7507/1007-4848.202108059

Video：

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The new effective systemic treatment strategy has "created" many long-term stage Ⅳ non-small cell lung cancer (NSCLC) survivors, and surgeons should pay attention to those individual ineffective lesions of long-term survivors. Besides, the new effective systemic treatment strategy may have changed the original concept and population of oligometasis. To intervene the oligo-progression lesions of long-term stage Ⅳ survivors, particularly after effective systemic treatment, at appropriate time with appropriate way might be the main task of surgery in the future.

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2.	Dingemans AC, Hendriks LEL, Berghmans T, et al. Definition of synchronous oligometastatic non-small cell lung cancer—A consensus report. J Thorac Oncol, 2019, 14(12): 2109-2119.
3.	Parikh RB, Cronin AM, Kozono DE, et al. Definitive primary therapy in patients presenting with oligometastatic non-small cell lung cancer. Int J Radiat Oncol Biol Phys, 2014, 89(4): 880-887.
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7.	Ramalingam SS, Vansteenkiste J, Planchard D, et al. Overall survival with osimertinib in untreated, egfr-mutated advanced NSCLC. N Engl J Med, 2020, 382(1): 41-50.
8.	Solomon BJ, Kim DW, Wu YL, et al. Final overall survival analysis from a study comparing first-line crizotinib versus chemotherapy in alk-mutation-positive non-small-cell lung cancer. J Clin Oncol, 2018, 36(22): 2251-2258.
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12.	Liu Y. Small cell lung cancer transformation from EGFR-mutated lung adenocarcinoma: A case report and literatures review. Cancer Biol Ther, 2018, 19(6): 445-449.
13.	Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol, 1995, 13(1): 8-10.
14.	Endo C, Hasumi T, Matsumura Y, et al. A prospective study of surgical procedures for patients with oligometastatic non-small cell lung cancer. Ann Thorac Surg, 2014, 98(1): 258-264.
15.	Pfannschmidt J, Dienemann H. Surgical treatment of oligometastatic non-small cell lung cancer. Lung Cancer, 2010, 69(3): 251-258.
16.	Villaruz LC, Kubicek GJ, Socinski MA. Management of non-small cell lung cancer with oligometastasis. Curr Oncol Rep, 2012, 14(4): 333-341.
17.	Patel AN, Simone CB 2nd, Jabbour SK. Risk factors and management of oligometastatic non-small cell lung cancer. Ther Adv Respir Dis, 2016, 10(4): 338-348.
18.	Arrieta O, Barrón F, Maldonado F, et al. Radical consolidative treatment provides a clinical benefit and long-term survival in patients with synchronous oligometastatic non-small cell lung cancer: A phaseⅡ study. Lung Cancer, 2019, 130: 67-75.
19.	Gomez DR, Blumenschein GR Jr, Lee JJ, et al. Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy: A multicentre, randomised, controlled, phase 2 study. Lancet Oncol, 2016, 17(12): 1672-1682.
20.	Gomez DR, Tang C, Zhang J, et al. Local consolidative therapy vs. maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer: long-term results of a multi-institutional, phase ⅱ, randomized study. J Clin Oncol, 2019, 37(18): 1558-1565.
21.	Jones GD, Lengel HB, Hsu M, et al. Management of synchronous extrathoracic oligometastatic non-small cell lung cancer. Cancers (Basel), 2021, 13(8): 1893.
22.	Mitchell KG, Farooqi A, Ludmir EB, etc. Pulmonary resection is associated with long-term survival and should remain a therapeutic option in oligometastatic lung cancer. J Thorac Cardiovasc Surg, 2021, 161(4): 1497-1504.

1. Little AG, Gay EG, Gaspar LE, etc. National survey of non-small cell lung cancer in the United States: Epidemiology, pathology and patterns of care. Lung Cancer, 2007, 57(3): 253-260.
2. Dingemans AC, Hendriks LEL, Berghmans T, et al. Definition of synchronous oligometastatic non-small cell lung cancer—A consensus report. J Thorac Oncol, 2019, 14(12): 2109-2119.
3. Parikh RB, Cronin AM, Kozono DE, et al. Definitive primary therapy in patients presenting with oligometastatic non-small cell lung cancer. Int J Radiat Oncol Biol Phys, 2014, 89(4): 880-887.
4. Loi M, Mazzella A, Mansuet-Lupo A, et al. Synchronous oligometastatic lung cancer deserves a dedicated management. Ann Thorac Surg, 2019, 107(4): 1053-1059.
5. Doll R. The pierre denoix memorial lecture: Nature and nurture in the control of cancer. Eur J Cancer, 1999, 35(1): 16-23.
6. Graham EA, Singer JJ. Successful removal of an entire lung for carcinoma of the bronchus. By Evarts A. Graham and J. J. Singer. JAMA, 1984, 251(2): 257-260.
7. Ramalingam SS, Vansteenkiste J, Planchard D, et al. Overall survival with osimertinib in untreated, egfr-mutated advanced NSCLC. N Engl J Med, 2020, 382(1): 41-50.
8. Solomon BJ, Kim DW, Wu YL, et al. Final overall survival analysis from a study comparing first-line crizotinib versus chemotherapy in alk-mutation-positive non-small-cell lung cancer. J Clin Oncol, 2018, 36(22): 2251-2258.
9. Vansteenkiste J, Manegold C, Serwatowski P, et al. Phase Ⅲ study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol, 2008, 26(21): 3543-3551.
10. Reck M, Rodríguez-Abreu D, Robinson AG, etc. Five-year outcomes with pembrolizumab versus chemotherapy for metastatic non-small-cell lung cancer with pd-l1 tumor proportion score ≥ 50. J Clin Oncol, 2021, 39(21): 2339-2349.
11. Herbst RS, Giaccone G, de Marinis F, et al. Atezolizumab for first-line treatment of pd-l1-selected patients with NSCLC. N Engl J Med, 2020, 383(14): 1328-1339.
12. Liu Y. Small cell lung cancer transformation from EGFR-mutated lung adenocarcinoma: A case report and literatures review. Cancer Biol Ther, 2018, 19(6): 445-449.
13. Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol, 1995, 13(1): 8-10.
14. Endo C, Hasumi T, Matsumura Y, et al. A prospective study of surgical procedures for patients with oligometastatic non-small cell lung cancer. Ann Thorac Surg, 2014, 98(1): 258-264.
15. Pfannschmidt J, Dienemann H. Surgical treatment of oligometastatic non-small cell lung cancer. Lung Cancer, 2010, 69(3): 251-258.
16. Villaruz LC, Kubicek GJ, Socinski MA. Management of non-small cell lung cancer with oligometastasis. Curr Oncol Rep, 2012, 14(4): 333-341.
17. Patel AN, Simone CB 2nd, Jabbour SK. Risk factors and management of oligometastatic non-small cell lung cancer. Ther Adv Respir Dis, 2016, 10(4): 338-348.
18. Arrieta O, Barrón F, Maldonado F, et al. Radical consolidative treatment provides a clinical benefit and long-term survival in patients with synchronous oligometastatic non-small cell lung cancer: A phaseⅡ study. Lung Cancer, 2019, 130: 67-75.
19. Gomez DR, Blumenschein GR Jr, Lee JJ, et al. Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy: A multicentre, randomised, controlled, phase 2 study. Lancet Oncol, 2016, 17(12): 1672-1682.
20. Gomez DR, Tang C, Zhang J, et al. Local consolidative therapy vs. maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer: long-term results of a multi-institutional, phase ⅱ, randomized study. J Clin Oncol, 2019, 37(18): 1558-1565.
21. Jones GD, Lengel HB, Hsu M, et al. Management of synchronous extrathoracic oligometastatic non-small cell lung cancer. Cancers (Basel), 2021, 13(8): 1893.
22. Mitchell KG, Farooqi A, Ludmir EB, etc. Pulmonary resection is associated with long-term survival and should remain a therapeutic option in oligometastatic lung cancer. J Thorac Cardiovasc Surg, 2021, 161(4): 1497-1504.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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