Local Consolidative Surgery for Oligometastatic Non-Small Cell Lung Cancer With Bone Metastasis

Area of Science:

• Oncology
• Thoracic Surgery
• Cancer Research

Background:

• Local consolidative therapy (LCT) improves outcomes in oligometastatic non-small cell lung cancer (NSCLC).
• Bone metastases (BM) are linked to worse prognosis following LCT.
• The impact of BM on survival after pulmonary resection in NSCLC is not well-established, especially with modern systemic therapies.

Purpose of the Study:

• To investigate the prognostic influence of bone metastases (BM) on survival outcomes in patients with oligometastatic non-small cell lung cancer (NSCLC) undergoing pulmonary resection.
• To evaluate whether the presence of BM affects overall survival (OS) and progression-free survival (PFS) in this patient cohort.

Main Methods:

• Retrospective analysis of 87 patients with oligometastatic NSCLC who underwent pulmonary resection between 1996 and 2023 across two centers.
• Patients were stratified based on the presence or absence of bone metastases (BM).
• Survival outcomes were analyzed using Kaplan-Meier curves and multivariable Cox regression models.

Main Results:

• Of 87 patients, 10 had bone metastases (+BM) and 77 did not (-BM).
• Median overall survival (OS) was similar between groups (39.2 months for +BM vs. 37.5 months for -BM, P = .45).
• Median progression-free survival (PFS) was also comparable (17.7 months for +BM vs. 18.4 months for -BM, P = .28), with BM not being an independent predictor for PFS or OS.

Conclusions:

• In contemporary oligometastatic NSCLC patients undergoing pulmonary resection as part of LCT, bone metastases did not portend poorer survival.
• These findings support considering aggressive LCT strategies, including pulmonary resection, for patients with oligometastatic NSCLC, even in the presence of bone involvement.
• Multidisciplinary teams should evaluate patients for comprehensive treatment approaches, potentially including surgical resection.