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{\u0022basePath\u0022:\u0022\\\/\u0022,\u0022pathPrefix\u0022:\u0022\u0022,\u0022highwire\u0022:{\u0022markup\u0022:[{\u0022requested\u0022:\u0022full-text\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;15\\\/8\\\/16-a\u0022},{\u0022requested\u0022:\u0022long\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;15\\\/8\\\/16-a\u0022}],\u0022ac\u0022:{\u0022spmdc;15\\\/8\\\/16-a\u0022:{\u0022access\u0022:{\u0022reprint\u0022:true,\u0022full\u0022:true},\u0022pisa_id\u0022:\u0022spmdc;15\\\/8\\\/16-a\u0022,\u0022atom_uri\u0022:\u0022\u0022,\u0022jcode\u0022:\u0022spmdc\u0022}}},\u0022googleanalytics\u0022:{\u0022trackOutbound\u0022:1,\u0022trackMailto\u0022:1,\u0022trackDownload\u0022:1,\u0022trackDownloadExtensions\u0022:\u00227z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip\u0022,\u0022trackUrlFragments\u0022:1},\u0022ajaxPageState\u0022:{\u0022js\u0022:{\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/jquery.cluetip.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.hoverIntent.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.bgiframe.min.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_at_symbol.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_article_reference_popup.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/contrib\\\/google_analytics\\\/googleanalytics.js\u0022:1,\u00220\u0022:1}}});\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Clink type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ESingle-organ metastasis and a low TN status (especially in combination), limited local metastasis, and active anticancer treatment are prognostic for a longer overall survival in patients with stage IV non\u2013small cell lung cancer, according to a retrospective analysis using the National Cancer Registry in The Netherlands. Overall survival is longer in patients whose disease is staged using 18-fluoro-deoxyglucose positron emission tomography imaging.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003E18-fluoro-deoxyglucose positron emission tomography imaging\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eadenocarcinoma\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eintrathoracic metastasis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eextrathoracic lymph node metastasis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Estage IV non\u2013small cell lung cancer\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ETN status\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eoncology trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EA retrospective analysis using the National Cancer Registry in The Netherlands has found that patients with metastasis to a single organ have a better prognosis compared with patients with metastasis in multiple organs, particularly when they also have a low TN status [Hendriks LE et al. \u003Cem\u003EAnn Oncol\u003C\/em\u003E. 2015]. The analysis was conducted in patients with stage IV non\u2013small cell lung cancer (NSCLC) to evaluate the prognostic effect of the number of organs with metastasis, the specific organs with metastasis, as well as the local disease status, and it was presented by Lizza E. Hendriks, MD, Maastricht University Medical Center, Maastricht, The Netherlands.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EA total of 11\u2005094 patients with histologically confirmed NSCLC entered into the database between January 2006 and December 2012 were included in this analysis. Study exclusions included a malignancy within the previous 5 years, stage IV disease according to TNM6 based solely on pulmonary metastasis, no documented metastasis sites or TNM classification, and no survival data. Their mean age was 65 years; 60% were men; and 73% had adenocarcinoma (AdC). Staging of the N compartment was conducted using clinical data, including histology and imaging studies (eg, computed tomography and positron emission tomography [PET]).\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EMetastasis to a single organ was identified in 5676 (51.2%) of patients, and bone was the most frequent site of metastasis (41.3%) in the overall cohort. Bone, brain, pleura, and lymph node metastases were more common in patients with AdC compared with squamous cell carcinoma. The investigators found that patients with single-organ metastasis were more likely to be older and have squamous NSCLC and a low TN status.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EThe median overall survival (OS) was significantly higher in patients with disease classified as TNM7 with intrathoracic metastasis (M1a) compared with distant metastasis (M1b) and compared with patients with TNM6 stage IV NSCLC (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16309\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16309\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16309\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EMedian Overall Survival by TNM Status\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EIn patients with metastasis to only 1 organ, compared with multiple organs, the OS was significantly higher (\u003Ca id=\u0022xref-table-wrap-2-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003ETable 2\u003C\/a\u003E). The risk for a shorter OS increased as the number of organs with metastasis increased (HR, 1.3 for 2 vs 1 organ; HR, 1.9 for \u2265\u20053 vs 1 organ; \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001 for both). The multivariable analysis showed that OS was significantly better in patients who were younger (\u0026lt;\u200550 years) and those who were women, as well as those who had AdC, TNM7 M1a cancer, metastasis to 1 organ, and limited local disease.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T2\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16310\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16310\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16310\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 2.\u003C\/span\u003E \n               \u003Cp id=\u0022p-10\u0022 class=\u0022first-child\u0022\u003EMedian OS by Degree of Organ Metastasis in Total and \u003Csup\u003E18\u003C\/sup\u003EFDG-PET Cohorts\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-12\u0022\u003EThe OS was longer in patients whose disease was staged using 18-fluoro-deoxyglucose PET imaging compared with the total cohort (\u003Ca id=\u0022xref-table-wrap-2-2\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003ETable 2\u003C\/a\u003E). As the number of organs with metastasis increased, the risk of a shorter OS also increased for this subgroup (HR, 1.4 for 2 vs 1 organ; HR, 2.2 for \u2265\u20053 vs 1 organ; \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001 for both).\u003C\/p\u003E\n         \u003Cp id=\u0022p-13\u0022\u003ESingle-organ metastasis plus a low TN status, compared with single-organ metastasis with a high TN status, conferred a longer OS in the total cohort (8.5 vs 6.5 months; HR, 1.4; \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001) and in the 18-fluoro-deoxyglucose PET cohort (11.6 vs 8.2 months; HR, 1.6; \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001). Moreover, it also conferred a longer OS in the subgroup of patients who were receiving active anticancer treatment. In these patients, the median OS was 10.4, 7.3, and 5.7 months for metastasis to 1, 2, or \u2265\u20053 organs, respectively; the HR was 1.4 and 1.9 for metastasis to 2 vs 1 organ and \u2265\u20053 vs 1 organ (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001).\u003C\/p\u003E\n         \u003Cp id=\u0022p-14\u0022\u003EThe TN status also predicted survival, with a median OS of 13.7 vs 9.9 months for patients with a low vs high TN status (HR, 1.5; \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001). In patients with single-organ metastasis, the OS was better only with intrathoracic M1a and extrathoracic lymph node metastasis, which included only current M1b lymph nodes. The HR was 0.6, 0.8, and 0.8 for pulmonary, pleural, and extrathoracic lymph node metastasis, respectively.\u003C\/p\u003E\n         \u003Cp id=\u0022p-15\u0022\u003EIn conclusion, the prognosis was better in stage IV NSCLC patients who had metastasis to only a single organ and a low TN status, who had metastasis limited to the intrathoracic region, and who were receiving active anticancer treatment. In the patients with distant metastasis, only those with an extrathoracic lymph node metastasis (ie, lymph nodes currently staged as M1b) had a better OS.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/8\/16.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlnjp\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzlnjp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}