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  P3.08 - Oligometastatic NSCLC (Not CME Accredited Session) (ID 974)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall

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    P3.08-08 - Outcomes of Pulmonary Metastasectomy in Breast Cancer: Prognosis Based on the Metastatic Lung Tumor Study Group of Japan (ID 12242)

    12:00 - 13:30  |  Author(s): Masafumi Kawamura
    • Abstract
    • Slides

    Background
    

    Although pulmonary metastasectomy is a common treatment in other primary cancers, its role in patients with primary breast cancer is still controversial. The purpose of this study was to analyze a Japanese multi-center database to assess the prognostic factors and indications of metastasectomy in breast cancer.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Data of 387 patients with histologically proven pulmonary metastases from breast cancer have been prospectively enrolled in the Metastatic Lung Tumor Study Group of Japan between December 1982 and March 2017. Those with inadequate information about perioperative data, surgery for biopsy, male or non–epithelial malignancies were excluded. A total of 253 female with invasive breast carcinoma between 1982 and 2017 constituted the study population, and their clinical and prognostic data were retrospectively analyzed.

    4c3880bb027f159e801041b1021e88e8 Result
    

    The median follow-up period was 5.4 (range, 0–24) years. The mean age of patients was 56 (range, 32–82) years, the median disease-free interval was 4.8 (range, 0–31) years, pulmonary metastasis (215 solitary, 38 multiple) was treated with surgeries, namely, wedge resection　(n = 113, 45%), segmentectomy (n = 22, 9%), lobectomy (n = 116, 45%), and pneumonectomy (n = 2, 1%). Nodal metastases were found in 56 (22%) patients. There were 24 (9%) patients with incomplete resection. Additional treatments after metastasectomy were performed in 141 patients (56%). Recurrence after pulmonary metastasectomy developed in 98 of 229 (43%) patients without incomplete resection, namely, intrathoracic lesion (n = 21, 23%), distant metastasis (n = 47, 51%), and unknown (n = 25, 27%). The 5-year and 10-year survival rates after pulmonary metastasectomy were 66% and 52%, respectively, and the median survival period was 10 years. In the univariate analysis, early treatment period (<2001; p = 0.02), short disease-free interval (<3 years; p < 0.01), large tumor size (>2 cm; p < 0.01), surgical procedure (lobectomy and pneumonectomy; p = 0.01), intrathoracic nodal metastasis (p < 0.01), and incomplete resection (p = 0.05) were shown to be associated with poor survival. Multivariate analysis revealed that only short disease-free interval (<3 years; p < 0.01) was significantly worse prognostic factor in 253 patients.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    The main poor prognostic factor was disease-free interval (<3 years). However, complete resection of metastases was not a significant prognostic factor. The efficacy of pulmonary metastasectomy in breast cancer is still controversy. For pulmonary metastais from breast cancer, pulmonary metastasectomy is considered to be optional treatment.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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