A risk stratification scheme for synchronous oligometastatic non-small cell lung cancer developed by a multicentre analysis

Lorenzo Spaggiari, Luca Bertolaccini, Francesco Facciolo, Filippo Tommaso Gallina, Federico Rea, Marco Schiavon, Stefano Margaritora, Maria Teresa Congedo, Marco Lucchi, Ilaria Ceccarelli, Marco Alloisio, Edoardo Bottoni, Riccardo Enzo Maria Bottoni, Giampiero Negri, Angelo Carretta, Giuseppe Cardillo, Sara Ricciardi, Enrico Ruffini, Lorena Costardi, Giovanni MurianaDomenico Viggiano, Michele Rusca, Luigi Ventura, Laura Ventura, Giuseppe Marulli, Angela De Palma, Lorenzo Rosso, Paolo Mendogni, Roberto Crisci, Andrea De Vico, Pio Maniscalco, Nicola Tamburini, Francesco Puma, Silvia Ceccarelli, Simona Ceccarelli, Luca Voltolini, Stefano Bongiolatti, Angelo Morelli, Francesco Londero

Research output: Contribution to journalArticle


Backgrounds: Oligometastatic Non-Small Cell Lung Cancer (NSCLC) patients represent a category without a standard therapeutic approach. However, in selected oligometastatic NSCLC, radical surgery seems to offer a good prognosis. This retrospective study aimed to analyse the long-term outcomes of synchronous oligometastatic patients treated with curative intent and identify the factors associated with better results and the proposal of a risk stratification system for classifying the synchronous oligometastatic NSCLC. Methods: The medical records of patients from 18 centres with pathologically diagnosed synchronous oligometastatic NSCLC were retrospectively reviewed. The inclusion criteria were synchronous oligometastatic NSCLC, radical surgical treatment of the primary tumour with or without neoadjuvant/adjuvant therapy and radical treatment of all metastatic sites. The Kaplan – Meier method estimated survivals. A stratified backward stepwise Cox regression model was assessed for multivariable survival analyses. Results: 281 patients were included. The most common site of metastasis was the brain, in 50.89 % patients. Median overall survival was 40 months (95 % CI: 29–53). Age ≤65 years (HR = 1.02, 95 % CI: 1.00–1.05; p = 0.019), single metastasis (HR = 0.71, 95 % CI: 0.45–1.13; p = 0.15) and presence of contralateral lung metastases (HR = 0.30, 95 % CI: 0.15 – 0.62; p = 0.001) were associated with a good prognosis. The presence of pathological N2 metastases negatively affected survival (HR = 2.00, 95 % CI: 1.21–3.32; p = 0.0065). These prognostic factors were used to build a simple risk classification scheme. Conclusions: Treatment of selected synchronous oligometastatic NSCLC with curative purpose could be conducted safely and at acceptable 5-year survival levels, especially in younger patients with pN0 disease.
Original languageEnglish
Pages (from-to)29-35
Number of pages7
JournalLung Cancer
Publication statusPublished - 2021


  • Biostatistics
  • Lung cancer
  • Oligometastatic
  • Risk classification
  • Thoracic surgery


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