Evidence map›Paper›PMID 34432390›Full record

ArticleCancer medicine2021

Late metastatic presentation is associated with improved survival and delayed wide-spread progression after ablative stereotactic body radiotherapy for oligometastasis.

Xuguang Chen, Hanbo Chen, Ian Poon, Darby Erler, Serena Badellino, Tithi Biswas, Roi Dagan, Matthew Foote, Alexander V Louie, Umberto Ricardi and 2 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Stereotactic ablative radiotherapy (SABR) for pelvic nodal oligorecurrence in prostate cancer.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2024
    Article
  4. Review
  5. Management of oligoprogression in non-small cell lung cancer patients.Medical oncology (Northwood, London, England) · 2022
    Review
  6. Article
  7. Review
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Xuguang ChenDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, USA.ORCID 0000-0001-8761-810X
Hanbo ChenDepartment of Radiation Oncology, Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-6447-653X
Ian PoonDepartment of Radiation Oncology, Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, Canada.
Darby ErlerDepartment of Radiation Oncology, Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, Canada.
Serena BadellinoOncology Department, University of Turin, Turin, Italy.
Tithi BiswasUniversity Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA.ORCID 0000-0002-9074-733X
Roi DaganDepartment of Radiation Oncology, University of Florida, Jacksonville, FL, USA.
Matthew FooteDepartment of Radiation Oncology, University of Queensland, Princess Alexandra Hospital, Queensland, Australia.
Alexander V LouieDepartment of Radiation Oncology, Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, Canada.
Umberto RicardiOncology Department, University of Turin, Turin, Italy.
Arjun SahgalDepartment of Radiation Oncology, Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, Canada.
Kristin J RedmondDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, USA.ORCID 0000-0003-3442-4613

Funding

Elekta
6 · The paper itself

Abstract

backgroundStereotactic body radiotherapy (SBRT) is increasingly used to treat oligometastatic disease (OMD), but the effect of metastasis timing on patient outcomes remains uncertain.

methodsAn international database of patients with OMD treated with SBRT was assembled with rigorous quality assurance. Early versus late metastases were defined as those diagnosed ≤24 versus >24 months from the primary tumor. Overall survival (OS), progression-free survival (PFS), and incidences of wide-spread progression (WSP) were estimated using multivariable Cox proportional hazard models stratified by primary tumor types.

resultsThe database consists of 1033 patients with median follow-up of 24.1 months (0.3-104.7). Late metastatic presentation (N = 427) was associated with improved OS compared to early metastasis (median survival 53.6 vs. 33.0 months, hazard ratio [HR] 0.59, 95% confidence interval [CI]: 0.47-0.72, p < 0.0001). Patients with non-small cell lung cancer (NSCLC, N = 255, HR 0.49, 95% CI: 0.33-0.74, p = 0.0005) and colorectal cancer (N = 235, HR 0.50, 95% CI: 0.30-0.84, p = 0.008) had better OS if presenting with late metastasis. Late metastasis correlated with longer PFS (median 17.1 vs. 9.0 months, HR 0.71, 95% CI: 0.61-0.83, p < 0.0001) and lower 2-year incidence of WSP (26.1% vs. 43.6%, HR 0.60, 95% CI: 0.49-0.74, p < 0.0001). Fewer WSP were observed in patients with NSCLC (HR 0.52, 95% CI: 0.33-0.83, p = 0.006) and kidney cancer (N = 63, HR 0.37, 95% CI: 0.14-0.97, p = 0.044) with late metastases. Across cancer types, greater SBRT target size was a significant predictor for worse OS.

conclusionLate metastatic presentation is associated with improved survival and delayed progression in patients with OMD treated with SBRT.

Indexed as

AdultAgedAged, 80 and overBreast NeoplasmsCarcinoma, Non-Small-Cell LungColorectal NeoplasmsDisease ProgressionFemaleFollow-Up StudiesHumansIncidenceKaplan-Meier EstimateKidney NeoplasmsLung NeoplasmsMaleMiddle Agedlate metastasismetastasis-directed radiotherapyoligometastasisSABRSBRTwide-spread progression

Identifiers

PMID34432390
PMCPMC8446561

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.