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A Comparison of 2 Disease Burden Assessment Methods (3D Volume Versus the Number of Lesions) for Prognostication of Survival in Metastatic Melanoma: Implications for the Characterization of Oligometastatic Disease.
Kim, Jina; Chang, Jee Suk; Sung, Wonmo; Kim, Jin Sung; Kim, Tae Hyung; Choi, Seo Hee; Kim, Kyung Hwan; Ko, Heejoo; Lee, Hye Sun; Jeon, Soyoung; Shin, Sang Joon; Liu, Mitchell; Olson, Robert.
Afiliación
  • Kim J; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea.
  • Chang JS; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea; BC Cancer, Vancouver Centre, Vancouver, BC, Canada. Electronic address: changjeesuk@yuhs.ac.
  • Sung W; Department of Biomedical Engineering and of Biomedicine & Health Sciences, College of Medicine, The Catholic University, Seoul, Korea.
  • Kim JS; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea. Electronic address: JINSUNG@yuhs.ac.
  • Kim TH; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea; Department of Radiation Oncology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
  • Choi SH; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea; Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-City, Korea.
  • Kim KH; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea.
  • Ko H; College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • Lee HS; Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.
  • Jeon S; Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.
  • Shin SJ; Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
  • Liu M; BC Cancer, Vancouver Centre, Vancouver, BC, Canada.
  • Olson R; BC Cancer, Centre for the North, Prince George, BC, Canada.
Int J Radiat Oncol Biol Phys ; 114(5): 883-891, 2022 12 01.
Article en En | MEDLINE | ID: mdl-36007725
PURPOSE: Oligometastatic disease (OMD), generally defined by the presence of ≤5 metastatic lesions, represents an intermediate state between localized and widespread metastatic disease. This study aimed to question the conventional definition of OMD and assess the significance of the total volume and loci of metastases in characterizing OMD using an unselected metastatic melanoma cohort. METHODS AND MATERIALS: We identified 86 consecutive patients with metastatic melanoma who received pembrolizumab monotherapy from 2015 to 2020. We retrospectively contoured the gross tumor volumes of all metastatic lesions on baseline and follow-up imaging. The number, total volume, and loci information of metastases was collected. The primary endpoint was overall survival. A density histogram plot was used for tumor characteristic descriptions, and classification analysis using the decision tree and random forest methods was performed to determine the optimal combination of prognostic factors in the clinical setting. RESULTS: A total of 2728 gross tumor volumes were delineated. On baseline imaging, the median number and total volume of metastases was 7 (interquartile range, 3-17) and 28.4 cc (interquartile range, 8.4-88.78), respectively. The lymph node was the most common metastatic site (n = 46, 54%), followed by the lungs (n = 32, 37%), liver (n = 23, 27%), and bones (n = 21, 24%). Two-year overall survival rates of patients with 1 to 5, 6 to 10, 11 to 20, and >20 metastases were 58%, 47%, 31%, and 14%, respectively, and with ≤10, 11 to 30, 31 to 130, and >130 cc of metastatic volume were 64%, 43%, 33%, and 25%, respectively. K-adaptive partitioning revealed that the optimal cutoff was 20 and 37.9 cc. Decision tree and random forest analyses revealed that volume and loci (brain and liver metastases) were the most important factors (Harrell's C-index, 0.78). CONCLUSIONS: The OMD state could represent a continuous spectrum of disease burden instead of a binary phenomenon. We propose integrating the volumetric and spatial information of metastases into the characterization of OMD and the stratification tool of clinical trials in the metastatic setting, although external validation studies are needed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Primarias Secundarias / Melanoma Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Int J Radiat Oncol Biol Phys Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Primarias Secundarias / Melanoma Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Int J Radiat Oncol Biol Phys Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos