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New preoperative classification scheme proposed for oligometastatic NSCLC

Presented By
Dr Luca Bertolaccini, European Institute of Oncology, Italy
WCLC 2021
Researchers have developed a risk classification scheme that, if validated, may inform decision making about patients with oligometastatic non-small-cell lung cancer (NSCLC). The scheme could also help to identify appropriate candidates for involvement in future clinical trials [1].

Dr Luca Bertolaccini (European Institute of Oncology, Italy) reminded delegates of his team’s previous retrospective study which analysed long-term outcomes of synchronous oligometastatic NSCLC patients who had been treated with radical surgery, with the intent of identifying factors associated with better outcomes. The longest survival times were observed in patients with synchronous lung oligometastatic/non-pN2 disease. The team’s next step was to identify preoperative risk factors which seemed to be associated with better post-surgical outcomes. Dr Bertolaccini shared the results of this multicentre retrospective study.

The median overall survival and progression-free survival periods were estimated by the reverse Kaplan-Meier method in a retrospective review of 281 patient records. Using a stratified backward stepwise Cox regression model, a prognostic risk classification scheme consisting of 4 groups was created. The parameters identified as contributory to prognosis were age, site of metastasis, clinical nodal status, and induction treatment. Using these 4 parameters, the following risk classification scheme was proposed:

  • Group A: no risk factors present;

  • Group B: 1 risk factor present;

  • Group C: 2 risk factors present; and

  • Group D: ≥3 risk factors present.

Patients in Group A had the longest overall survival, while patients in Group D had the shortest overall survival.

Dr Bertolaccini emphasised that for optimal outcomes in oligometastatic NSCLC, patient selection is critical to identify appropriate subsets. He proposed that, following validation of this preoperative risk classification scheme, it may be used to support decision making regarding patient management, as well as to assist appropriate patient selection for future clinical trials.

  1. Bertolaccini L. PREC multicentre retrospective study: A preoperative risk classification for synchronous oligometastatic non-small cell lung cancer. MA 01.03, WCLC 2021, 8–14 September.


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