Background:Oligometastatic non-small cell lung cancer (NSCLC) represents a biologically and clinically distinct state characterized by limited metastatic spread. Increasing evidence suggests that aggressive local therapies, including surgical resection, may confer a survival benefit in this population. The objective of this review is to evaluate the current role of surgery in the management of oligometastatic NSCLC, with emphasis on patient selection, surgical strategy, integration with systemic therapy, and ongoing clinical investigations.Methods:This narrative review synthesizes retrospective and prospective clinical data, meta-analyses, major consensus guidelines, and ongoing trials since 2012. We highlight prognostic factors, staging strategies, and the evolving role of molecular and biomarker-based stratification.Results:Multiple retrospective studies and several randomized trials have demonstrated improved progression-free and overall survival with local consolidative therapy in oligometastatic NSCLC. Prognostic factors associated with favorable outcomes include a limited number of metastases (≤3), good performance status, absence of mediastinal nodal disease, metachronous presentation, and actionable molecular alterations. The integration of surgery with systemic therapies, including targeted agents and immunotherapy, has become increasingly common in selected patients. Ongoing trials such as LONESTAR, NORTHSTAR, and BRIGHTSTAR are expected to further define the role of surgery in this setting.Conclusions:Surgery is emerging as a key component of multimodal treatment for carefully selected patients with oligometastatic NSCLC. Future efforts should focus on refining patient selection through molecular stratification and expanding prospective trial data to guide personalized biology-driven treatment strategies.
背景：寡转移性非小细胞肺癌（NSCLC）是一种具有生物学与临床独特性的疾病状态，其特征为有限的转移扩散。越来越多的证据表明，包括手术切除在内的积极局部治疗可能为该类患者带来生存获益。本综述旨在评估当前手术在寡转移性NSCLC治疗中的作用，重点关注患者选择、手术策略、与全身治疗的整合以及正在进行的临床研究。 方法：本叙述性综述综合了2012年以来的回顾性与前瞻性临床数据、荟萃分析、主要共识指南及进行中的临床试验。我们重点分析了预后因素、分期策略，以及基于分子和生物标志物分层策略的演变。 结果：多项回顾性研究和若干随机试验已证实，局部巩固治疗可改善寡转移性NSCLC患者的无进展生存期和总生存期。与良好预后相关的因素包括转移灶数量有限（≤3个）、体能状态良好、无纵隔淋巴结转移、异时性转移以及存在可干预的分子变异。在特定患者中，手术与全身治疗（包括靶向药物和免疫治疗）的联合应用日益普遍。LONESTAR、NORTHSTAR和BRIGHTSTAR等正在进行的研究有望进一步明确手术在此类疾病中的作用。 结论：对于经过严格筛选的寡转移性NSCLC患者，手术正逐渐成为多模式治疗的关键组成部分。未来的研究重点应是通过分子分层优化患者选择，并扩展前瞻性试验数据，以指导个性化的生物学驱动治疗策略。
Surgical Management of Oligometastatic Non-Small Cell Lung Cancer
肿瘤(癌症)患者之家