The consideration of surgery on primary lesion of advanced non-small cell lung cancer.
BMC Pulm Med
; 23(1): 118, 2023 Apr 14.
Article
en En
| MEDLINE
| ID: mdl-37060050
ABSTRACT
BACKGROUND:
Numerous reports have shown that medical treatment confers excellent survival benefits to patients with advanced stage IV non-small cell lung cancer (NSCLC). However, the implications of surgery for primary lesions as palliative treatment remain inconclusive.METHODS:
We retrospectively extracted clinical data from the Surveillance, Epidemiology, and End Results Program (SEER) database and selected patients with stage IV NSCLC. Patients were classified into non-surgery and surgery groups, and propensity score matching (PSM) analysis was performed to balance the baseline information. Patients in the surgery group, whose overall survival (OS) was longer than the median survival time of those in the non-surgery group, were deemed to benefit from surgery. We evaluated the efficacy of three surgical techniques, namely, local destruction, sub-lobectomy, and lobectomy, on the primary site in the beneficial population.RESULTS:
The results of Cox regression analyses revealed that surgery was an independent risk factor for both OS (hazard ratio [HR] 0.441; confidence interval [CI] 0.426-0.456; P < 0.001) and cancer-specific survival (CSS) (HR 0397; CI 0.380-0.414; P < 0.001). Notably, patients who underwent surgery had a better prognosis than those who did not (OS P < 0.001; CSS P < 0.001). Moreover, local destruction and sub-lobectomy significantly compromised survival compared to lobectomy in the beneficial group (P < 0.001). After PSM, patients with stage IV disease who underwent lobectomy needed routine mediastinal lymph node clearing (OS P = 0.0038; CSS P = 0.039).CONCLUSION:
Based on these findings, we recommend that patients with stage IV NSCLC undergo palliative surgery for the primary site and that lobectomy plus lymph node resection should be conventionally performed on those who can tolerate the surgery.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Carcinoma de Pulmón de Células no Pequeñas
/
Neoplasias Pulmonares
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
BMC Pulm Med
Año:
2023
Tipo del documento:
Article
País de afiliación:
China