ARCHIVES OF THE BALKAN MEDICAL UNION

Oligometastatic lung cancer? Treating the patient, not the disease

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Introduction: The recommended treatment for patients with metastatic non-small cell lung cancer is either chemotherapy or palliative care involving surgery for amending symptoms. Discussion: A small number of patients with lung cancer has a limited number of extra-thoracic metastases (oligometastases). Some of these patients may benefit from resection of both primary and metastatic sites, in addition to systemic treatment, with the goal of increasing survival and achieving curability. Retrospective studies show that patients with oligometastatic lung cancer can achieve long-term survival if the surgical treatment achieves complete resection of the primary and all evident metastatic sites. Adrenal and brain metastases deserve special attention as they are well documented in literature. Adrenal metastases are believed to be a consequence of lymphatic dissemination rather than hematogenous spread.

Conclusions: Overall survival of patients with adrenal metastases treated with chemotherapy alone seems to be less than for those treated through chemotherapy and surgical resection of all known diseases. Resection or radiosurgical ablation of an isolated brain metastasis is recommended, and adjuvant chemotherapy and adjuvant whole-brain radiotherapy are suggested. Abreviations: NSCLC – non small cell lung cancer

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