P-191
MULTIMODAL TREATMENT FOR OLIGOMETASTATIC NON-SMALL CELL LUNG CANCER: AN EXCITING CHALLENGE Free

Objectives: Oligometastatic non-small cell lung cancer (NSCLC) is a subgroup of tumours presenting a better clinical behaviour than other IV stage tumours. In selected cases aggressive treatment seems to show a good prognosis. We want to identify prognostic factors associated with long survivals in our copious clinical records.

Methods: We enlarged our published experience ranging from January 1997 to December 2013 presenting a retrospective analysis of 67 patients (mean age: 59.4 ± 10.6) with synchronous NSCLC treated with curative intent on both primary and metastastic sites. All patients underwent radical thoracic resection with hilar and mediastinal lymphadenectomy. All patients with radiological suspicion of N2 disease were subjected to mediastinoscopy or, more recently, EUS-EBUS endoscopy. Thirty-five patients underwent induction therapy (chemo or radio-chemotherapy) and 20 had a pathological downstaging. Forty-seven patients received adjuvant therapy.

Results: Forty-six patients had brain metastases, nine had bone or vertebral metastases, eight had adrenal metastases; other sites of metastatization were liver, pancreas, supraclavicular lymph-node. In 11 cases two metastases have been found; four patients had multiple metastatic sites. Surgery was the most common treatment for the metastases (50 [74.6%] patients). Radicality was achieved in 54 (80.6%) patients. Overall one- and five-year survival were 46% and 24%, respectively (median follow-up: 17 months). Kaplan-Meier median overall survival was 19 months. After stepwise multivariate analysis, weight loss (P < 0.02), clinical T- (P = 0.008) and N-stage (P = 0.011), surgical treatment of metastatic P = 0.01) and completeness of pulmonary resection (P = 0.039) maintained their independent prognostic value as overall survival determinants.

Conclusion: Oligometastasic lung cancer is an exciting challenge for oncologic surgeons. In our experience favourable survivals seem to be associated with radicality, clinical status and surgical treatment of metastatic site. Future prospective clinical trials are necessary to identify which subgroup of patients and which therapeutic pathway could be appropriated for a multimodal treatment.

Disclosure: No significant relationships.