What is the clinical evidence from this study?

Study design: Review. Population: Adrenal oligometastases secondary to non-small cell lung cancer (n=521). Intervention: Surgery or radiotherapy vs. Palliative chemotherapy. Primary outcome: Median overall survival.

January 1, 2017touchREVIEWS in Oncology & HaematologyOpen Access

Aggressive local treatment of adrenal oligometastases secondary to NSCLC yielded median overall survivals of 9.5-64 months after surgery and 8-23 months after radiotherapy, compared to 6-8.5 months after chemotherapy.

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Why the study?

Does aggressive local treatment (surgery or radiotherapy) improve overall survival in patients with adrenal oligometastases secondary to non-small cell lung cancer compared to palliative chemotherapy?

Population

521 patients from 29 studies with adrenal oligometastases secondary to non-small cell lung cancer (NSCLC).

Comparison

Aggressive local treatment, specifically… vs Palliative chemotherapy alone.

Design

Systematic_review

Key result

Aggressive local treatment of adrenal oligometastases secondary to NSCLC yielded median overall survivals of 9.5-64 months after surgery and 8-23 months after radiotherapy, compared to 6-8.5 months after chemotherapy.

Authors

BTBryce Thomsen AFAlysa Fairchild

Discussion

Member takes

Overview

May support aggressive local therapy for selected adrenal OM in NSCLC; leaves open survival benefit due to low-quality retrospective data.

Structured PICO

Population

521 patients with adrenal oligometastases secondary to non-small cell lung cancer included across 29 studies evaluating surgical resection or radiotherapy.

Intervention

Aggressive local treatment, specifically surgical resection (adrenalectomy) or radiotherapy (including stereotactic body radiation therapy).

Comparator

Palliative chemotherapy alone (in 4 studies comparing surgery to contemporaneous cohorts).

Outcome

Overall survival (OS)hard clinical

Aggressive local treatment of adrenal oligometastases in NSCLC with surgery or radiotherapy may be associated with improved overall survival compared to palliative chemotherapy, though evidence is limited to small, mostly retrospective studies.

Limitations

Paucity of high quality evidence, with 26 of 29 included studies being retrospective.
No publications directly compared surgery and radiotherapy modalities.
Significant selection bias, as patients receiving aggressive treatment likely had less bulky disease, better performance status, and lower overall disease burden.
Heterogeneity in intrathoracic stage, treatment of primary disease, and follow-up protocols across the included studies.
Paucity of high quality evidence (26 of 29 studies were retrospective)
No publications directly comparing surgery and radiotherapy modalities
Small sample sizes in included studies (average 20.2 for surgery, 9.3 for RT)
Selection bias in studies comparing surgery to palliative chemotherapy

Cite This Study

Thomsen et al. (2017) conducted a review in Adrenal oligometastases secondary to non-small cell lung cancer (n=521). Surgery or radiotherapy vs. Palliative chemotherapy was evaluated on Median overall survival. Aggressive local treatment of adrenal oligometastases secondary to NSCLC yielded median overall survivals of 9.5-64 months after surgery and 8-23 months after radiotherapy, compared to 6-8.5 months after chemotherapy.

synapsesocial.com/papers/6a9a9bde3be7bd97fa0e565f https://doi.org/10.17925/ohr.2017.13.02.117

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January 1, 2017touchREVIEWS in Oncology & HaematologyOpen Access

Aggressive local treatment of adrenal oligometastases secondary to NSCLC yielded median overall survivals of 9.5-64 months after surgery and 8-23 months after radiotherapy, compared to 6-8.5 months after chemotherapy.

View Full Paper

Ask AI

Bookmark

Why the study?

Population

521 patients from 29 studies with adrenal oligometastases secondary to non-small cell lung cancer (NSCLC).

Comparison

Aggressive local treatment, specifically… vs Palliative chemotherapy alone.

Design

Systematic_review

Key result

Authors

BTBryce Thomsen AFAlysa Fairchild

Discussion

Member takes

Overview

May support aggressive local therapy for selected adrenal OM in NSCLC; leaves open survival benefit due to low-quality retrospective data.

Structured PICO

Population

521 patients with adrenal oligometastases secondary to non-small cell lung cancer included across 29 studies evaluating surgical resection or radiotherapy.

Intervention

Aggressive local treatment, specifically surgical resection (adrenalectomy) or radiotherapy (including stereotactic body radiation therapy).

Comparator

Palliative chemotherapy alone (in 4 studies comparing surgery to contemporaneous cohorts).

Outcome

Overall survival (OS)hard clinical

Limitations

Paucity of high quality evidence, with 26 of 29 included studies being retrospective.
No publications directly compared surgery and radiotherapy modalities.
Significant selection bias, as patients receiving aggressive treatment likely had less bulky disease, better performance status, and lower overall disease burden.
Heterogeneity in intrathoracic stage, treatment of primary disease, and follow-up protocols across the included studies.
Paucity of high quality evidence (26 of 29 studies were retrospective)
No publications directly comparing surgery and radiotherapy modalities
Small sample sizes in included studies (average 20.2 for surgery, 9.3 for RT)
Selection bias in studies comparing surgery to palliative chemotherapy

Cite This Study

synapsesocial.com/papers/6a9a9bde3be7bd97fa0e565f https://doi.org/10.17925/ohr.2017.13.02.117

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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