SUCCESSFUL TREATMENT OF SOLITARY EXTRACRANIAL METASTASES FROM NON-SMALL-CELL LUNG-CANCER

Background Recurrence after resection of non-small cell lung carcinoma is generally associated with a poor outcome and is treated with eithe r systemic agents or palliative irradiation. Recently, long-term survi val has been reported after resection of isolated brain metastases fro m non-small cell lung carcinoma, but resection of other metastatic sit es has not been explored fully. Methods. We have identified 14 patient s who had solitary extracranial metastases treated aggressively after curative treatment of their non-small cell lung carcinoma. The histolo gy was squamous carcinoma in 5, adenocarcinoma in 8, and large cell ca rcinoma in 1. Initially, 3 patients had stage I,5 stage II, and 6 stag e IIIa disease. Results. The sites of metastases included extrathoraci c lymph nodes (six), skeletal muscle (four), bone (three), and small b owel (one). The median disease-free interval before metastases was 19. 5 months (range, 5 to 71 months). Complete surgical resection of the m etastatic site was the treatment in 12 of 14 patients. Two patients re ceived only curative irradiation to the metastatic site, with complete response. The overall 10-year actuarial survival (Kaplan-Meier) was 8 6%. To date, 11 patients are alive and well after treatment of their m etastases (17 months to 13 years), 1 has recurrent disease, 1 died of recurrent widespread metastases, and 2 died of unrelated causes. Concl usion. Long-term survival is possible after treatment of isolated meta stases to various sites from nonsmall cell lung carcinoma, but patient selection is critical.