2Department of Thoracic Surgery, Health Sciences University, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
3Department of Thoracic Surgery Memorial Hospital, Istanbul, Turkey DOI : 10.26663/cts.2025.009 Viewed : 59 - Downloaded : 23 Background: Although stage IV non-small cell lung cancer (NSCLC) is often considered incurable, a growing body of evidence suggests that patients with oligometastatic disease-characterized by a limited number of metastases-may benefit from aggressive local treatment. This study evaluates the outcomes of patients with synchronous extrathoracic oligometastases and explores factors influencing survival.
Materials and Methods: We retrospectively analyzed 35 consecutive patients (4 females, 31 males) diagnosed with NSCLC who presented with synchronous extrathoracic metastases. All patients underwent standardized staging, including cervical mediastinoscopy, and, where feasible, both the primary tumor and metastatic lesions were managed with curative intent (surgery or ablative therapies).
Results: Overall mean survival was 38 ± 6 months; when hospital mortality (n = 4) was excluded, mean survival rose to 43 ± 7 months with a median of 27 months. The 1-, 2-, and 5-year survival rates were 58.9%, 47.7%, and 38.1%, respectively. Brain metastases were the most frequent site (74% of patients), and patients with brain metastases insignificantly exhibited higher mortality compared to other metastasis sites. Neither age, smoking history, nor tumor laterality significantly affected survival, and histological subtype did not confer a clear survival advantage.
Conclusions: In selected patients with synchronous oligometastatic NSCLC, aggressive treatment targeting both the primary tumor and metastases can extend survival beyond historical expectations for stage IV disease. Further large-scale prospective studies are needed to identify the subgroups most likely to benefit from bifocal (primary and metastatic) surgical management.
Keywords : non-small cell lung cancer, synchronous metastasis, oligometastatic disease, lobectomy