Long-Term Survival in Patients with Oligometastatic Non-Small Cell Lung Cancer by a Multimodality Treatment—Comparison with Stage III Disease
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Patients
2.2. Statistical Analysis
3. Results
3.1. Baseline Patient Characteristics
3.2. OMD Patients
3.3. Stage III Patients
3.4. Overall Survival and Progression-Free Survival
3.5. Cross-Validated Prognostic Survival Classifier for the OMD Patient Cohort
3.6. Propensity Score Weighted Survival Analysis: Age, CRP at Diagnosis, Sex, Severe Comorbidity
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient, Tumor and Treatment Characteristics | Stage III (N [%]) | OMD (N [%]) | p-Value |
---|---|---|---|
Age in years: median (range) Age groups: <40 y/40–≤60 y/60–≤70 y/>70 y | 64.9 (43.6–87.0) 0/65/85/70 [0.0/29.5/38.6/31.8] | 63.8 (38.7–87.8) 1/16/23/12 [1.9/30.8/44.2/23.1] | 0.1060 |
Sex: male/female | 150/70 [68.2/31.8] | 33/19 [63.5/36.5] | 0.6252 |
T-category: T1/T2/T3/T4 | 19/32/48/121 [8.6/14.5/21.8/55.0] | 5/10/15/22 [9.6/19.2/28.9/42.3] | 0.3762 |
N-category: N0/N1/N2/N3 | 44/20/114/42 [20.0/9.1/51.8/19.1] | 13/2/24/13 [25.0/3.8/46.2/25.0] | 0.4183 |
M-category: M0/M1a/M1b/M1c | 220/0/0/0 [100/0/0/0] | 0/15/24/13 [0/28.8/46.2/25] | <0.0001 |
UICC Stage: IIIA/IIIB/IIIC/IVA/IVB | 100/91/29/0/0 [45.4/41.4/13.2/0/0] | 0/0/0/44/8 [0/0/0/84.6/15.4] | <0.0001 |
Thoracic stage, ignoring M-category: IIB/IIIA/IIIB/IIIC | 0/100/91/29 [0/45.4/41.4/13.2] | 3/21/21/7 [5.8/40.4/40.4/13.5] | 0.0249 |
ECOG performance status: 0/1/2/3 | 99/92/29/0 [45/41.8/13.2/0] | 25/21/6/0 [48.1/40.4/11.5/0] | 0.9308 |
Pre-existing comorbidity classified as grade > 2 according to CTC-AE-version 5: yes vs. no | 63/157 [28.6/71.4] | 9/43 [17.3/82.7] | 0.1161 |
Histology: squamous/non-squamous | 113/107 [51.4/48.6] | 13/39 [25.0/75.0] | 0.0006 |
COPD GOLD: 0–I/II/III/IV (%) | 85/101/27/7 [38.6/45.9/12.3/3.2] | 27/21/4/0 [51.9/40.4/7.7/0] | 0.2680 |
PD-L1 expression: 0%/1%–<50%/≥50%/(n/d) | 69/63/27/61 [31.4/28.6/12.3/27.7] | 27/10/9/6 [51.9/19.2/17.3/11.5] | 0.0076 |
18F-FDG-PET/CT before therapy: no/yes | 18/202 [8.2/91.8] | 0/52 [0/100] | 0.0289 |
EBUS-TBNA before therapy: no/yes | 17/203 [7.7/92.3] | 4/48 [7.7/92.3] | 1.0000 |
Patient, Tumor and Treatment Characteristics | Stage III (N [%]) | OMD (N [%]) | p-Value |
---|---|---|---|
Hemoglobin at diagnosis in g/dL: median (range) | 13.5 (7.8–17.9) | 13.4 (9.4–16.2) | 0.9885 |
LDH at diagnosis in U/L: median (range) | 218 (114–1116) | 217 (99–398) | 0.6869 |
CRP at diagnosis in mg/dL: median (range) | 1.45 (0.0–25.0) | 1.50 (0.0–13.8) | 0.5041 |
Patient, Tumor and Treatment Characteristics | Stage III (N [%]) | OMD (N [%]) | p-Value |
---|---|---|---|
Treatment modality: Definitive radiochemotherapy/Trimodality treatment (%) | 158/62 [71.8/21.2] | 45/7 [86.5/13.5] | 0.0328 |
Total radiation dose in Gy: Median (interquartile range) | 61.0 (47.0–65.5) | 60.0 (60.0–64.0) | 0.5372 |
Date of Start of radiotherapy: Days from 1 August 2016, Median (range) | 687 (17–1286) | 707 (158–1556) | 0.7555 |
ICI Line: none (0)/1/2/3 | 124/38/54/4 [56.4/17.3/24.5/1.8] | 18/5/26/3 [34.6/9.6/50.0/5.8] | 0.0007 |
Therapy of synchronous distant metastases: systemic therapy (ST) alone/ST + RT/ST + surgery | Not applicable | 7/29/16 [13.5/55.8/30.8] | Not applicable |
HR (95%-CI (Range)) | p-Value | |
---|---|---|
Sex: female vs. male | 0.405 (0.190–0.866) | 0.0198 |
Severe comorbidity | 2.552 (1.149–5.669) | 0.0214 |
C-reactive protein * | 1.130 (1.035–1.234) | 0.0063 |
ECOG status ** | 2.102 (1.057–4.179) | 0.0342 |
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Guberina, M.; Pöttgen, C.; Guberina, N.; Hoffmann, C.; Wiesweg, M.; Richlitzki, C.; Metzenmacher, M.; Aigner, C.; Bölükbas, S.; Gauler, T.; et al. Long-Term Survival in Patients with Oligometastatic Non-Small Cell Lung Cancer by a Multimodality Treatment—Comparison with Stage III Disease. Cancers 2024, 16, 1174. https://doi.org/10.3390/cancers16061174
Guberina M, Pöttgen C, Guberina N, Hoffmann C, Wiesweg M, Richlitzki C, Metzenmacher M, Aigner C, Bölükbas S, Gauler T, et al. Long-Term Survival in Patients with Oligometastatic Non-Small Cell Lung Cancer by a Multimodality Treatment—Comparison with Stage III Disease. Cancers. 2024; 16(6):1174. https://doi.org/10.3390/cancers16061174
Chicago/Turabian StyleGuberina, Maja, Christoph Pöttgen, Nika Guberina, Christian Hoffmann, Marcel Wiesweg, Cedric Richlitzki, Martin Metzenmacher, Clemens Aigner, Servet Bölükbas, Thomas Gauler, and et al. 2024. "Long-Term Survival in Patients with Oligometastatic Non-Small Cell Lung Cancer by a Multimodality Treatment—Comparison with Stage III Disease" Cancers 16, no. 6: 1174. https://doi.org/10.3390/cancers16061174
APA StyleGuberina, M., Pöttgen, C., Guberina, N., Hoffmann, C., Wiesweg, M., Richlitzki, C., Metzenmacher, M., Aigner, C., Bölükbas, S., Gauler, T., Eberhardt, W. E. E., Forsting, M., Herrmann, K., Theegarten, D., Darwiche, K., Jendrossek, V., Stuschke, M., & Schuler, M. (2024). Long-Term Survival in Patients with Oligometastatic Non-Small Cell Lung Cancer by a Multimodality Treatment—Comparison with Stage III Disease. Cancers, 16(6), 1174. https://doi.org/10.3390/cancers16061174