In the article by Hammerschmidt and Woitz, I missed a comment on the group of patients with stage IV non-small cell lung cancer as a result of isolated metastases in the brain or adrenal glands. After extrathoracic tumor manifestations have been ruled out and adequate locoregional therapy of the primary tumor has been ensured, in individual cases an indication may exist for curative stereotactic radiotherapy or surgery, which may increase 5 years survival rates to around 20–30% (1, 2). This approach is recommended in the current guidelines and should not be withheld from the appropriate-albeit small-group of patients.
Footnotes
Conflict of interest statement
The author declares that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.
References
- 1.et al. Tanvetyanon. Outcomes of adrenalectomy for isolated synchronous versus metachronous adrenal metastases in non-small-cell lung cancer: a systematic review and pooled analysis. J Clin Oncol. 2008;26:1142–1147. doi: 10.1200/JCO.2007.14.2091. [DOI] [PubMed] [Google Scholar]
- 2.et al. Flannery. Long-term survival in patients with synchronous, solitary brain metastasis from non-small-cell-lung cancer treated with radiosurgery. Int J Radiation Oncology Biol Phys. 2008;72:19–23. doi: 10.1016/j.ijrobp.2007.12.031. [DOI] [PubMed] [Google Scholar]