La maladie oligométastatique dans le cancer bronchique non à petites cellules

Oligometastatic non-small cell lung cancers are an infrequent feature comprising 1 to 5 metastatic sites only which may be synchrones (diagnosed within 6 months after primary site) or metachrones. The major sites which have been studied, mainly as case report's, are adrenal glands, brain, and lung in which bifocal surgery and/or stereotactic radiation therapy have been proposed associated in most instances with systemic treatment. Longterm survival may be observed essentially if there is no mediastinal lymph nodes involved. Even more infrequently, oligometastatic lung tumors involving bone, skin, liver, kidney… have been reported as being amenable to radical treatment. In those cases also, the main prognostic factor is the involvement of mediastinal nodes. The exact role of systemic treatment remains to be established as in all cases isolated reports have been described. It is more than probable that these oligometastatic non-small cell lung cancer which do not progress toward plutimetastatic forms have a special biological profile as some studies recently suggested.