Shimada Yoshihisa
Department of Thoracic Surgery, Tokyo Medical University, Tokyo 160-0023, Japan.
Cancers (Basel). 2024 Dec 6;16(23):4086. doi: 10.3390/cancers16234086.
Despite the introduction of effective systemic therapies and advancements in precision medicine, recurrence or progression remains common in advanced non-small cell lung cancer (NSCLC). For a subset of patients with more localized metastatic disease-referred to as oligometastases and oligo-recurrence-emerging evidence suggests that a multimodal approach combining systemic therapy with local ablative therapies (LATs) may offer curative potential. Oligo-recurrence is defined by the presence of a limited number of metastases and recurrences in patients with controlled primary lesions. In this review, we focus on providing a comprehensive overview of the evidence supporting the concepts of oligo-recurrence in lung cancer, which is considered one of the most curable states among advanced diseases. Although the definition remains variable and is still under discussion, retrospective studies have reported that it is not a rare condition (occurring in 18-53% of cases) and shows relatively better survival outcomes regardless of whether a local ablative therapy (LAT) is performed. However, this classification remains a topic of ongoing debate and warrants further exploration. In addition to an ongoing randomized clinical trial on oligo-recurrent NSCLC, further rigorous studies specifically addressing oligo-recurrence are needed to refine treatment strategies for this advanced yet potentially curable state. These investigations are essential for developing effective, tailored approaches to optimize outcomes for patients within this prognostically favorable subgroup.
尽管引入了有效的全身治疗方法且精准医学取得了进展，但晚期非小细胞肺癌（NSCLC）的复发或进展仍然很常见。对于一部分具有更局限性转移疾病的患者——称为寡转移和寡复发——新出现的证据表明，将全身治疗与局部消融治疗（LATs）相结合的多模式方法可能具有治愈潜力。寡复发的定义是原发性病灶得到控制的患者中存在数量有限的转移灶和复发灶。在这篇综述中，我们重点全面概述支持肺癌寡复发概念的证据，肺癌寡复发被认为是晚期疾病中最可治愈的状态之一。尽管定义仍不统一且仍在讨论中，但回顾性研究报告称，这并非罕见情况（发生率为18% - 53%），并且无论是否进行局部消融治疗（LAT），其生存结果相对较好。然而，这种分类仍然是一个持续争论的话题，值得进一步探索。除了一项正在进行的关于寡复发NSCLC的随机临床试验外，还需要进一步针对寡复发进行严格研究，以完善针对这种晚期但可能治愈状态的治疗策略。这些研究对于制定有效、个性化的方法以优化该预后良好亚组患者的治疗结果至关重要。
