| Background: Metastatic disease has often been regarded as an end-stage disease, makingalmost all M1patients candidates for only Palliative treatment. However, due toprognostic significance, evidence in oligometastatic patients following local therapy withcurative intent, the treatment trend towards managing such patients as a separate entity,seems imminent.Objective: To evaluate the prognostic benefit of local therapy in the treatment of patientswith limited metastatic disease, Oligometastasis. The meta-analysis was conducted inApril2013.Methods and Materials: Systematic search on Pubmed and Sciencedirect was conducted.Different journals between January1990and December2012were identified andrelevant studies on the subject randomly picked.Selection criteria included clinical studies that specifically talked about oligometastaticdisease of the lung. Information on patients involved in each individual study, modalityof treatment used and prognostic outcome after treatment were extracted. The studiesselected included only those published in English language. Meta analytical methodswere used to compute the summary of overall survival.Results: After a very close scrutiny only three studies met the criteria for the analysis.The total number of patients was156and overall survival data were obtainable for all thepatients. Seventy-four patients in the control group and eighty-two patients in the localtreatment group, HR were pooled under the fixed-effects model for overall survival. Theresults showed the local treatment group to have a significantly better survival than thecontrol group.Conclusion: The findings suggest that local therapy (surgery or radiotherapy) given tooligometastatic patients provide significant prognostic advantage to these patients.However, the study has had a number of limitations including population bias and smallsample size giving it a low statistical power. The usefulness of these local therapies forOligometastasis should be clarified by prospective studies in the future. |
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