Is it time for redefining oligometastatic disease? Analysis of lung metastases CT in ten tumor types
Abstract Background Oligometastatic disease (OD) is usually defined arbitrarily as a condition in which there are ≤ 5 metastases. Given limited disease, it is expected that patients with OD should have better prognosis compared to other metastatic patients and that they can potentially benefit from...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Springer
2023-02-01
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| Series: | Discover Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s12672-023-00625-2 |
| _version_ | 1811165815823663104 |
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| author | Ofer N. Gofrit Ben Gofrit Yuval Roditi Aron Popovtzer Steve Frank Jacob Sosna S. Nahum Goldberg |
| author_facet | Ofer N. Gofrit Ben Gofrit Yuval Roditi Aron Popovtzer Steve Frank Jacob Sosna S. Nahum Goldberg |
| author_sort | Ofer N. Gofrit |
| collection | DOAJ |
| description | Abstract Background Oligometastatic disease (OD) is usually defined arbitrarily as a condition in which there are ≤ 5 metastases. Given limited disease, it is expected that patients with OD should have better prognosis compared to other metastatic patients and that they can potentially benefit from metastasis-directed therapy (MDT). In this study, we attempted to redefine OD based upon objective evidence that fulfill these assumptions. Methods Chest CTSs of 773 patients with 15,947 lung metastases originating from ten malignancy types were evaluated. The number and largest diameter of each metastasis was recorded. Metastatic cluster was defined as a cluster of two or more metastases with diameter difference ≤ 1 mm. The prognostic power of seven statistical models on overall survival (OS) was analyzed. Findings Both the number of metastases and metastatic clusters had a highly significant impact on OS (p < 0.0001, p = 0.003 respectively). Patients with a single metastasis or a single cluster of metastases (regardless of metastases number), equaling 16.2% of all patients, had significantly better prognosis compared to other patients (p = 0.0002). If metastases diameter variability is ignored, as in the standard definition of OD, then patients with 2–5 and 6–10 metastases would have a similar prognosis. Interpretation Patients with a single cluster of metastases, theoretically originating from a single clone, have significantly better prognosis compared to patients with more than one cluster. Using this definition can potentially improve the results of MDT. The upper limit of metastases number should be determined by the technical capabilities of the MDT used. |
| first_indexed | 2024-04-10T15:42:57Z |
| format | Article |
| id | doaj.art-10fd161a301a45bb94b046c11b871942 |
| institution | Directory Open Access Journal |
| issn | 2730-6011 |
| language | English |
| last_indexed | 2024-04-10T15:42:57Z |
| publishDate | 2023-02-01 |
| publisher | Springer |
| record_format | Article |
| series | Discover Oncology |
| spelling | doaj.art-10fd161a301a45bb94b046c11b8719422023-02-12T12:15:34ZengSpringerDiscover Oncology2730-60112023-02-011411910.1007/s12672-023-00625-2Is it time for redefining oligometastatic disease? Analysis of lung metastases CT in ten tumor typesOfer N. Gofrit0Ben Gofrit1Yuval Roditi2Aron Popovtzer3Steve Frank4Jacob Sosna5S. Nahum Goldberg6Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of JerusalemSchool of Engineering and Computer Science, Hebrew University of JerusalemSchool of Engineering and Computer Science, Hebrew University of JerusalemDepartment of Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of JerusalemDepartment of Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of JerusalemDepartment of Radiology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of JerusalemDepartment of Radiology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of JerusalemAbstract Background Oligometastatic disease (OD) is usually defined arbitrarily as a condition in which there are ≤ 5 metastases. Given limited disease, it is expected that patients with OD should have better prognosis compared to other metastatic patients and that they can potentially benefit from metastasis-directed therapy (MDT). In this study, we attempted to redefine OD based upon objective evidence that fulfill these assumptions. Methods Chest CTSs of 773 patients with 15,947 lung metastases originating from ten malignancy types were evaluated. The number and largest diameter of each metastasis was recorded. Metastatic cluster was defined as a cluster of two or more metastases with diameter difference ≤ 1 mm. The prognostic power of seven statistical models on overall survival (OS) was analyzed. Findings Both the number of metastases and metastatic clusters had a highly significant impact on OS (p < 0.0001, p = 0.003 respectively). Patients with a single metastasis or a single cluster of metastases (regardless of metastases number), equaling 16.2% of all patients, had significantly better prognosis compared to other patients (p = 0.0002). If metastases diameter variability is ignored, as in the standard definition of OD, then patients with 2–5 and 6–10 metastases would have a similar prognosis. Interpretation Patients with a single cluster of metastases, theoretically originating from a single clone, have significantly better prognosis compared to patients with more than one cluster. Using this definition can potentially improve the results of MDT. The upper limit of metastases number should be determined by the technical capabilities of the MDT used.https://doi.org/10.1007/s12672-023-00625-2OligometastasesDefinitionClonal originCluster of metastasesPrognosis |
| spellingShingle | Ofer N. Gofrit Ben Gofrit Yuval Roditi Aron Popovtzer Steve Frank Jacob Sosna S. Nahum Goldberg Is it time for redefining oligometastatic disease? Analysis of lung metastases CT in ten tumor types Discover Oncology Oligometastases Definition Clonal origin Cluster of metastases Prognosis |
| title | Is it time for redefining oligometastatic disease? Analysis of lung metastases CT in ten tumor types |
| title_full | Is it time for redefining oligometastatic disease? Analysis of lung metastases CT in ten tumor types |
| title_fullStr | Is it time for redefining oligometastatic disease? Analysis of lung metastases CT in ten tumor types |
| title_full_unstemmed | Is it time for redefining oligometastatic disease? Analysis of lung metastases CT in ten tumor types |
| title_short | Is it time for redefining oligometastatic disease? Analysis of lung metastases CT in ten tumor types |
| title_sort | is it time for redefining oligometastatic disease analysis of lung metastases ct in ten tumor types |
| topic | Oligometastases Definition Clonal origin Cluster of metastases Prognosis |
| url | https://doi.org/10.1007/s12672-023-00625-2 |
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