{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:07:24Z","timestamp":1790316444284,"version":"4.1.0"},"reference-count":47,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,17]],"date-time":"2024-03-17T00:00:00Z","timestamp":1710633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: In patients with oligometastatic NSCLC, a cT3\u2013cT4 primary tumor or an cN2\/cN3 lymph node status was reported to be associated with unfavorable outcome. The aim of this study was to assess the importance of definitive or neoadjuvant thoracic radiochemotherapy for long-term outcome of these patients in order to find more appropriate treatment schedules. Methods: Analysis of the West Cancer Centre (WTZ) institutional database from 08\/2016 to 08\/2020 was performed. Patients with primary synchronous OMD, all without actionable driver mutations, who received definitive thoracic radiochemotherapy (RCT) or neoadjuvant RCT followed by surgery (trimodality treatment) were included. Survival outcome is compared with stage III NSCLC. Results: Altogether, 272 patients received concurrent radiochemotherapy. Of those, 220 presented with stage III (158 with definitive RCT, 62 with trimodality approach). A total of 52 patients had OMD patients with cT3\/cT4 or cN2\/cN3 tumors. Overall survival (OS) at five years for OMD patients was 28.3% (95%-CI: 16.4\u201341.5%), which was not significantly different from OS of patients with stage III NSCLC treated with definitive or neoadjuvant RCT (34.9% (95%-CI: 27.4\u201342.8%)). However, the PFS of OMD patients at five years or last follow-up was significantly worse than that of stage III patients (13.0% vs. 24.3%, p = 0.0048). The latter was due to a higher cumulative incidence of distant metastases in OMD patients (50.2% vs. 20.4% at 48 months, p &lt; 0.0001) in comparison to stage III patients. A cross-validated classifier that included severe comorbidity, ECOG performance status, gender and pre-treatment serum CRP level as the most important factors in the univariable analysis, was able to divide the OMD patient group into two equally sized groups with a four-year survival rate of 49.4% in the good prognosis group and 9.9% in the poor prognosis group (p = 0.0021). Laboratory chemistry and clinical parameters, in addition to imaging and high-precision therapies, can help to predict and improve prognosis. Conclusions: A multimodality treatment approach and local metastases-directed therapy in addition to chemoimmunotherapy can lead to good long-term survival in patients with cT3\/cT4 or cN2\/cN3 OMD NSCLC without severe comorbidities and in good performance status and is therefore recommended.<\/jats:p>","DOI":"10.3390\/cancers16061174","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T04:25:15Z","timestamp":1710735915000},"page":"1174","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Long-Term Survival in Patients with Oligometastatic Non-Small Cell Lung Cancer by a Multimodality Treatment\u2014Comparison with Stage III Disease"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3218-0539","authenticated-orcid":false,"given":"Maja","family":"Guberina","sequence":"first","affiliation":[{"name":"Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"},{"name":"National Center for Tumor Diseases (NCT) West, Campus Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9224-9318","authenticated-orcid":false,"given":"Christoph","family":"P\u00f6ttgen","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nika","family":"Guberina","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"},{"name":"National Center for Tumor Diseases (NCT) West, Campus Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5776-439X","authenticated-orcid":false,"given":"Christian","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Wiesweg","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"},{"name":"Division of Thoracic Oncology, West German Cancer Center, University Medicine Essen\u2014Ruhrlandklinik, 45239 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cedric","family":"Richlitzki","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"},{"name":"Department of Radiation Oncology, University Hospital, LMU Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Metzenmacher","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7787-991X","authenticated-orcid":false,"given":"Clemens","family":"Aigner","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery and Thoracic Endoscopy, West German Cancer Center, University Medicine Essen\u2014Ruhrlandklinik, University Duisburg-Essen, 45239 Essen, Germany"},{"name":"Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8275-5957","authenticated-orcid":false,"given":"Servet","family":"B\u00f6l\u00fckbas","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery and Thoracic Endoscopy, West German Cancer Center, University Medicine Essen\u2014Ruhrlandklinik, University Duisburg-Essen, 45239 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Gauler","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried E. E.","family":"Eberhardt","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"},{"name":"Division of Thoracic Oncology, West German Cancer Center, University Medicine Essen\u2014Ruhrlandklinik, 45239 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Forsting","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic, Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Herrmann","sequence":"additional","affiliation":[{"name":"National Center for Tumor Diseases (NCT) West, Campus Essen, 45147 Essen, Germany"},{"name":"Department of Nuclear Medicine, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Theegarten","sequence":"additional","affiliation":[{"name":"Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0681-1325","authenticated-orcid":false,"given":"Kaid","family":"Darwiche","sequence":"additional","affiliation":[{"name":"Section of Interventional Pneumology, Department of Pulmonary Medicine, West German Cancer Center, University Medicine Essen\u2014Ruhrlandklinik, University Duisburg-Essen, 45239 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1058-2107","authenticated-orcid":false,"given":"Verena","family":"Jendrossek","sequence":"additional","affiliation":[{"name":"Institute for Cell Biology (Cancer Research), University Hospital Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6836-0940","authenticated-orcid":false,"given":"Martin","family":"Stuschke","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"},{"name":"National Center for Tumor Diseases (NCT) West, Campus Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2166-3394","authenticated-orcid":false,"given":"Martin","family":"Schuler","sequence":"additional","affiliation":[{"name":"National Center for Tumor Diseases (NCT) West, Campus Essen, 45147 Essen, Germany"},{"name":"Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"},{"name":"Division of Thoracic Oncology, West German Cancer Center, University Medicine Essen\u2014Ruhrlandklinik, 45239 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1200\/JCO.1995.13.1.8","article-title":"Oligometastases","volume":"13","author":"Hellman","year":"1995","journal-title":"J. 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