[The Significance of Surgery for Oligometastatic and Oligoprogressive Non-small Cell Lung Cancer]. / Die Bedeutung der Chirurgie beim oligometastatischen und oligoprogressiven nicht kleinzelligen Lungenkarzinom.

ABSTRACT

An increased understanding of tumour biology as well as novel therapeutic options have led to a further differentiation of metastatic non-small cell lung cancer. Oligometastatic lung cancer has a relatively benign clinical course with few metastases, which are often confined to a single organ. To create the best outcomes, the ideal treatment must be used for each individual tumor biology, with consideration of the different treatment modalities. Surgery is of increasing significance in curative treatment concepts in metastatic lung cancers. In analogy to oligometastatic disease, the term "oligoprogression" has emerged in recent years. This describes a state in which metastatic lung cancers which express sensitizing mutations show progression of disease only at a limited number of anatomical sites whilst under therapy with tyrosine kinase inhibitors. Current studies have shown encouraging results for surgical therapy in combination with systemic therapy of both oligometastatic and oligoprogressive disease in well selected patients. It remains to be determined whether the observed survival benefits are based on the favourable tumour biology or the applied treatment modalities. Moreover, robust molecular markers have to be determined to identify patients who will benefit from aggressive surgical treatment, in order to avoid overtreatment.