Letter to the Editor
Oligo-Recurrence From a Lung Adenocarcinoma. Usefulness of Resection
Oligorrecurrencia a partir de un adenocarcinoma del pulmón. Utilidad de la resección
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Usefulness of Resection" "tieneTextoCompleto" => true "saludo" => "Dear Madam:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "46" "paginaFinal" => "47" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Miguel Emilio García Rodríguez, Bárbaro Agustín Armas Pérez, Karina Armas Moredo" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Miguel Emilio" "apellidos" => "García Rodríguez" "email" => array:1 [ 0 => "grmiguel@finlay.cmw.sld.cu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Bárbaro Agustín" "apellidos" => "Armas Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Karina" "apellidos" => "Armas Moredo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Facultad de Medicina, Universidad de Ciencias Médicas Carlos J. Finlay, Camagüey, Cuba" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Cirugía General, Hospital Universitario Amalia Simoni Argilagos, Camagüey, Cuba" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Neumología, Hospital Universitario Amalia Simoni Argilagos, Camagüey, Cuba" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Oligorrecurrencia a partir de un adenocarcinoma del pulmón. Utilidad de la resección" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 702 "Ancho" => 1343 "Tamanyo" => 153064 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Left panel: magnetic resonance imaging of the head showing a metastatic lesion with contrast uptake in the left temporal lobe and perilesional inflammatory lesions. Right panel: computed tomography of abdomen showing a metastatic lesion of the right adrenal gland.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Non-small cell lung cancer (LC) accounts for 80%–85% of all the varieties of this neoplasm, with adenocarcinoma being the most common histological type.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The prognosis of this disease is poor due to low survival and high recurrence rates.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> We present here a patient who presented oligo-recurrences during the course of his disease, which were treated surgically.</p><p id="par0010" class="elsevierStylePara elsevierViewall">This is a male, 42-year-old smoker investigated due to a lung shadow appearing on an unrelated chest X-ray. Computed tomography (CT) showed central radiodensity 4<span class="elsevierStyleHsp" style=""></span>cm×2<span class="elsevierStyleHsp" style=""></span>cm in the upper left lobe, without adenomegalies. Fiber optic bronchoscopy and aspiration cytology gave a diagnosis of epithelial type LC, confirmed by frozen section biopsy during thoracotomy, which was complemented by left upper lobectomy and mediastinal lymphadenectomy (stations 5–7 and 10). The post-operative histopathological result showed predominantly solid, mucin producing, poorly differentiated invasive adenocarcinoma, with no epidermal growth factor receptor overexpression or mutation and metastases in two aortopulmonary window lymph nodes. Treatment was complemented with sequential chemotherapy.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Nine months later, the patient presented visual disturbances and vertigo. Magnetic resonance imaging of the head with contrast medium was performed and a single tumor lesion was found in the left temporal lobe (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, right panel). Metastasectomy with adjuvant radiotherapy was performed. Five months later, abdominal tumoration of the right adrenal gland was detected on an abdominal ultrasound (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, left panel), confirmed on a CT scan with contrast. Adrenalectomy was performed. The patient is currently in follow-up, 5 years after the last procedure.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The terms oligo-metastasis, proposed by Hellman and Wechselbaum in 1995 and revised by Niibe et al. in 2006 to oligo-recurrence<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> are LC stages in which metastases or recurrences (between 1 and 5 lesions) can be treated with local treatments. The differences originate in the control of the primary tumor and how it appeared: in oligo-recurrence, the primary tumor is controlled and recurrence is metachronous; in oligometastases, the opposite occurs. In brief, oligo-recurrence is a metachronous, oligometastatic state where the primary tumor is controlled.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Positron emission tomography has reduced the diagnosis of oligo-recurrences, since many of them are metastatic in the initial diagnosis. However, despite being included in the diagnostic protocols, these imaging studies are not available in some countries.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Control of the primary tumor, nutritional status, histological type and the number of metastases are factors which impact on the treatment of oligo-recurrence.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5</span></a> However, a determinant factor for survival is the presence or absence of metastatic lymph node involvement (0%–35%).<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In view of the current technological advances and the use of local and systemic treatments, surgery<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5</span></a> is appropriate for some patients with oligo-recurrences. Our patient, despite having N2 lymph nodes, has had good survival, reinforcing the “seed and soil” theory of interaction between the cell and host in LC or in any other type of cancer.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García Rodríguez ME, Armas Pérez BA, Armas Moredo K. Oligorrecurrencia a partir de un adenocarcinoma del pulmón. Utilidad de la resección. Arch Bronconeumol. 2014;50:46–47.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 702 "Ancho" => 1343 "Tamanyo" => 153064 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Left panel: magnetic resonance imaging of the head showing a metastatic lesion with contrast uptake in the left temporal lobe and perilesional inflammatory lesions. Right panel: computed tomography of abdomen showing a metastatic lesion of the right adrenal gland.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "<span class="elsevierStyleBold">References</span>" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global cancer statistics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Jemal" 1 => "F. Bray" 2 => "M.M. Center" 3 => "J. Ferlay" 4 => "E. Ward" 5 => "D. 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| 2021 July | 42 | 37 | 79 |
| 2021 June | 61 | 28 | 89 |
| 2021 May | 40 | 27 | 67 |
| 2021 April | 72 | 95 | 167 |
| 2021 March | 48 | 37 | 85 |
| 2021 February | 29 | 24 | 53 |
| 2021 January | 26 | 23 | 49 |
| 2020 December | 31 | 36 | 67 |
| 2020 November | 22 | 27 | 49 |
| 2020 October | 21 | 23 | 44 |
| 2020 September | 33 | 5 | 38 |
| 2020 August | 36 | 19 | 55 |
| 2020 July | 31 | 21 | 52 |
| 2020 June | 23 | 7 | 30 |
| 2020 May | 22 | 19 | 41 |
| 2020 April | 33 | 15 | 48 |
| 2020 March | 23 | 12 | 35 |
| 2020 February | 32 | 16 | 48 |
| 2020 January | 24 | 23 | 47 |
| 2019 December | 51 | 35 | 86 |
| 2019 November | 29 | 26 | 55 |
| 2019 October | 33 | 7 | 40 |
| 2019 September | 23 | 12 | 35 |
| 2019 August | 24 | 13 | 37 |
| 2019 July | 22 | 12 | 34 |
| 2019 June | 24 | 8 | 32 |
| 2019 May | 29 | 11 | 40 |
| 2019 April | 39 | 23 | 62 |
| 2019 March | 44 | 20 | 64 |
| 2019 February | 32 | 19 | 51 |
| 2019 January | 37 | 11 | 48 |
| 2018 December | 36 | 13 | 49 |
| 2018 November | 39 | 19 | 58 |
| 2018 October | 62 | 17 | 79 |
| 2018 September | 28 | 13 | 41 |
| 2018 May | 12 | 1 | 13 |
| 2018 April | 27 | 4 | 31 |
| 2018 March | 19 | 2 | 21 |
| 2018 February | 38 | 7 | 45 |
| 2018 January | 19 | 6 | 25 |
| 2017 December | 28 | 5 | 33 |
| 2017 November | 22 | 4 | 26 |
| 2017 October | 22 | 8 | 30 |
| 2017 September | 27 | 9 | 36 |
| 2017 August | 35 | 9 | 44 |
| 2017 July | 31 | 4 | 35 |
| 2017 June | 49 | 12 | 61 |
| 2017 May | 36 | 5 | 41 |
| 2017 April | 30 | 8 | 38 |
| 2017 March | 31 | 42 | 73 |
| 2017 February | 24 | 3 | 27 |
| 2017 January | 18 | 5 | 23 |
| 2016 December | 35 | 4 | 39 |
| 2016 November | 52 | 10 | 62 |
| 2016 October | 53 | 19 | 72 |
| 2016 September | 45 | 13 | 58 |
| 2016 August | 48 | 8 | 56 |
| 2016 July | 31 | 7 | 38 |
| 2016 March | 3 | 0 | 3 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 46 | 3 | 49 |
| 2015 September | 35 | 7 | 42 |
| 2015 August | 40 | 10 | 50 |
| 2015 July | 35 | 9 | 44 |
| 2015 June | 34 | 7 | 41 |
| 2015 May | 45 | 18 | 63 |
| 2015 April | 34 | 12 | 46 |
| 2015 March | 45 | 10 | 55 |
| 2015 February | 34 | 6 | 40 |
| 2015 January | 44 | 11 | 55 |
| 2014 December | 26 | 14 | 40 |
| 2014 November | 40 | 9 | 49 |
| 2014 October | 46 | 12 | 58 |
| 2014 September | 33 | 12 | 45 |
| 2014 August | 35 | 21 | 56 |
| 2014 July | 47 | 8 | 55 |
| 2014 June | 62 | 11 | 73 |
| 2014 May | 45 | 16 | 61 |
| 2014 April | 45 | 14 | 59 |
| 2014 March | 0 | 1 | 1 |
| 2014 February | 0 | 2 | 2 |
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