1264P - Overall survival analysis of stage IV non small cell lung cancer with synchronous isolated metastasis in a large retrospective cohort of 4935 patie...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Non-Small Cell Lung Cancer
Presenter Anne Claire Toffart
Citation Annals of Oncology (2014) 25 (suppl_4): iv426-iv470. 10.1093/annonc/mdu349
Authors A.C. Toffart1, M. Duruisseaux2, H. Nagy-Mignotte2, L. Sakhri2, P.Y. Brichon3, J. Villa4, D. Hoffmann5, P. Guillem6, J.F. Timsit1, D. Moro-Sibilot2
  • 1Equipe 11, Institut Albert Bonniot-UJF-INSERM U823, 38700 - La Tronche/FR
  • 2Thoracic Oncology, CHU de Grenoble, 38700 - La Tronche/FR
  • 3Service De Chirurgie Thoracique, CHU de Grenoble, 38700 - Grenoble/FR
  • 4Service De Radiothérapie, CHU de Grenoble, 38700 - La Tronche/FR
  • 5Service De Neurochirurgie, CHU de Grenoble, 38700 - La Tronche/FR
  • 6Centre De Coordination En Cancérologie, CHU de Grenoble, 38700 - La Tronche/FR



Aim: Stage IV NSCLC is considered as an incurable disease with median survival of approximately 12 months. Palliative platinum based chemotherapy is the standard therapy. It has been suggested that patient with one synchronous isolated metastasis (SIM) suitable for local therapy (LT) have longer survival.


Methods: Database of the Multidisciplinary Thoracic Oncology Group of our centre was retrospectively screened from 1993 to 2012. Consecutive NSCLC of any stage were included. Major prognostic characteristics at diagnosis (gender, age, PS, smoking habit, histology), stage with details of metastatic site and survival follow up should be available. Median overall survival (OS) were compared with log-rank test.


4935 patients were registered, 18 were excluded because of missing data. Among the study population (n = 4917), 36.11% was stage III NSCLC (n = 1769) and 33.02% stage IV (n = 1512). Clinical and histological data differed substantially between each stage. OS was significantly different for any stage compared each other. Among stage IV, 7.27% was SIM (110/1512). SIM site was brain in 64% of cases and adrenal gland in 15% of cases. OS was significantly longer in SIM stage IV compared to non-SIM stage IV (18.8 months [IQR, 9.8-34.6] vs 6.3 months [IQR, 2.4-14.1], respectively, p < 0.0001). OS was not significantly different between SIM stage IV and stage III (18.8 months [IQR, 9.8-34.6] vs 15.3 months [IQR, 2.4-14.1], respectively, p = 0.63). There is a trend to an improve OS in the sub group of SIM stage IV with surgical LT of primitive and metastatic site (55/110) compared to other SIM stage IV (24.9 months [IQR 13.7-41.3 months] vs 15.8 months [IQR 5.8-51.6], respectively, p = 0.11).


Conclusion: OS of SIM stage IV is remarkably improved compared to non SIM stage IV, and comparable to stage III. Statistical analysis of survival should be balanced with prognostic covariates. This data support aggressive treatment in the subgroup of SIM stage IV.


All authors have declared no conflicts of interest.