Surgical Survival Benefits With Different Metastatic Patterns for Stage IV Extrathoracic Metastatic Non-Small Cell Lung Cancer: A SEER-Based Study

Overview

Journal Technol Cancer Res Treat

Specialties Biomedical Engineering
Oncology
Pharmacology

Date 2021 Sep 9

PMID 34496678

Citations 4

Authors

Ce Chao

Yongxiang Qian

Xihao Li

Chen Sang

Bin Wang

Xiao-Ying Zhang

Affiliations

Soon will be listed here.

Abstract

Background: With the knowledge of oligometastases, primary surgery plays an increasingly vital role in metastatic non-small cell lung cancer. We aimed to evaluate the survival benefit of primary surgery based on metastatic patterns.

Materials And Methods: The selected patients with stage IV extrathoracic metastatic (m1b) non-small cell lung cancer between 2010 and 2015 were included in a retrospective cohort study from the Surveillance, Epidemiology, and End Results (SEER) database. Multiple imputation was used for the missing data. Patients were divided into 2 groups depending on whether surgery was performed. After covariate balancing propensity score (CBPS) weighting, multivariate Cox regression models and Kaplan-Meier survival curve were built to identify the survival benefit of different metastatic patterns.

Results: Surgery can potentially increase the overall survival (OS) (adjusted HR: 0.68, < 0.001) of non-small cell lung cancer. The weighted 3-year OS in the surgical group was 16.9%, compared with 7.8% in the nonsurgical group. For single organ metastasis, surgery could improve the survival of metastatic non-small cell lung cancer. Meanwhile, no significant survival improvements in surgical group were observed in patients with multiple organ metastases.

Conclusion: The surgical survival benefits for extrathoracic metastatic non-small cell lung cancer could be divided by metastatic pattern.

Citing Articles

Optimal therapeutic strategy for non-small cell lung cancer with thoracic extrathoracic metastasis: a study based on SEER database.

He Z, Sun X, Xu J, Wang L, Cheng J, Lv W J Thorac Dis. 2024; 16(2):1021-1033.

PMID: 38505038 PMC: 10944759. DOI: 10.21037/jtd-23-516.

Distant organ metastasis patterns and prognosis of lung adenosquamous carcinoma: a SEER database analysis.

Xing H, Wu C, Zhang D, Zhang X Interdiscip Cardiovasc Thorac Surg. 2024; 38(2).

PMID: 38216548 PMC: 10838212. DOI: 10.1093/icvts/ivae007.

Clinical characteristics and prognosis of non-small cell lung cancer patients with liver metastasis: A population-based study.

Wang J, Lu H, Wang Y, Zhang R, Li X, Wang S World J Clin Cases. 2022; 10(30):10882-10895.

PMID: 36338221 PMC: 9631152. DOI: 10.12998/wjcc.v10.i30.10882.

Development and validation of a dynamic survival nomogram for metastatic non-small cell lung cancer based on the SEER database and an external validation cohort.

Wang Q, Wang Y, Wang X, Nakamura Y, Hydbring P, Yamauchi Y Transl Lung Cancer Res. 2022; 11(8):1678-1691.

PMID: 36090634 PMC: 9459611. DOI: 10.21037/tlcr-22-544.

References

Liao Y, Fan X, Wang X . Effects of different metastasis patterns, surgery and other factors on the prognosis of patients with stage IV non-small cell lung cancer: A Surveillance, Epidemiology, and End Results (SEER) linked database analysis. Oncol Lett. 2019; 18(1):581-592. PMC: 6546983. DOI: 10.3892/ol.2019.10373. View

Li J, Zhu H, Sun L, Xu W, Wang X . Prognostic value of site-specific metastases in lung cancer: A population based study. J Cancer. 2019; 10(14):3079-3086. PMC: 6603375. DOI: 10.7150/jca.30463. View

Jairam V, Park H, Decker R . Local Ablative Therapies for Oligometastatic and Oligoprogressive Non-Small Cell Lung Cancer. Cancer J. 2020; 26(2):129-136. DOI: 10.1097/PPO.0000000000000433. View

David E, Clark J, Cooke D, Melnikow J, Kelly K, Canter R . The Role of Thoracic Surgery in the Therapeutic Management of Metastatic Non-Small Cell Lung Cancer. J Thorac Oncol. 2017; 12(11):1636-1645. PMC: 5690551. DOI: 10.1016/j.jtho.2017.08.008. View

Siegel R, Miller K, Jemal A . Cancer statistics, 2020. CA Cancer J Clin. 2020; 70(1):7-30. DOI: 10.3322/caac.21590. View

Herbst R, Morgensztern D, Boshoff C . The biology and management of non-small cell lung cancer. Nature. 2018; 553(7689):446-454. DOI: 10.1038/nature25183. View

Giaj-Levra N, Giaj Levra M, Berghmans T, Novello S, Hendriks L, Levy A . Oligometastatic non-small cell lung cancer (NSCLC): Does number of metastasis matter?. Lung Cancer. 2019; 139:216-218. DOI: 10.1016/j.lungcan.2019.11.005. View

Kim C, Hoang C, Kesarwala A, Schrump D, Guha U, Rajan A . Role of Local Ablative Therapy in Patients with Oligometastatic and Oligoprogressive Non-Small Cell Lung Cancer. J Thorac Oncol. 2016; 12(2):179-193. DOI: 10.1016/j.jtho.2016.10.012. View

Casiraghi M, Bertolaccini L, Sedda G, Petrella F, Galetta D, Guarize J . Lung cancer surgery in oligometastatic patients: outcome and survival. Eur J Cardiothorac Surg. 2020; 57(6):1173-1180. DOI: 10.1093/ejcts/ezaa005. View

10.

Planchard D, Popat S, Kerr K, Novello S, Smit E, Faivre-Finn C . Metastatic non-small cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018; 29(Suppl 4):iv192-iv237. DOI: 10.1093/annonc/mdy275. View

11.

Hanagiri T, Takenaka M, Oka S, Shigematsu Y, Nagata Y, Shimokawa H . Results of a surgical resection for patients with stage IV non--small-cell lung cancer. Clin Lung Cancer. 2011; 13(3):220-4. DOI: 10.1016/j.cllc.2011.05.006. View

12.

Xu Z, Yang Q, Chen X, Zheng L, Zhang L, Yu Y . Clinical associations and prognostic value of site-specific metastases in non-small cell lung cancer: A population-based study. Oncol Lett. 2019; 17(6):5590-5600. PMC: 6507334. DOI: 10.3892/ol.2019.10225. View

13.

De Ruysscher D, Wanders R, Hendriks L, van Baardwijk A, Reymen B, Houben R . Progression-Free Survival and Overall Survival Beyond 5 Years of NSCLC Patients With Synchronous Oligometastases Treated in a Prospective Phase II Trial (NCT 01282450). J Thorac Oncol. 2018; 13(12):1958-1961. DOI: 10.1016/j.jtho.2018.07.098. View

14.

Gomez D, Blumenschein Jr G, Lee J, Hernandez M, Ye R, Camidge D . Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy: a multicentre, randomised, controlled, phase 2 study. Lancet Oncol. 2016; 17(12):1672-1682. PMC: 5143183. DOI: 10.1016/S1470-2045(16)30532-0. View

15.

Downey R, Ng K, Kris M, Bains M, Miller V, Heelan R . A phase II trial of chemotherapy and surgery for non-small cell lung cancer patients with a synchronous solitary metastasis. Lung Cancer. 2002; 38(2):193-7. DOI: 10.1016/s0169-5002(02)00183-6. View

16.

Ettinger D, Wood D, Aggarwal C, Aisner D, Akerley W, Bauman J . NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 1.2020. J Natl Compr Canc Netw. 2019; 17(12):1464-1472. DOI: 10.6004/jnccn.2019.0059. View

17.

De Ruysscher D, Wanders R, van Baardwijk A, Dingemans A, Reymen B, Houben R . Radical treatment of non-small-cell lung cancer patients with synchronous oligometastases: long-term results of a prospective phase II trial (Nct01282450). J Thorac Oncol. 2012; 7(10):1547-55. DOI: 10.1097/JTO.0b013e318262caf6. View

18.

Gibson A, Li H, DSilva A, Tudor R, Elegbede A, Otsuka S . Impact of number versus location of metastases on survival in stage IV M1b non-small cell lung cancer. Med Oncol. 2018; 35(9):117. DOI: 10.1007/s12032-018-1182-8. View

19.

Schanne D, Heitmann J, Guckenberger M, Andratschke N . Evolution of treatment strategies for oligometastatic NSCLC patients - A systematic review of the literature. Cancer Treat Rev. 2019; 80:101892. DOI: 10.1016/j.ctrv.2019.101892. View

20.

Yang J, Zhang Y, Sun X, Gusdon A, Song N, Chen L . The prognostic value of multiorgan metastases in patients with non-small cell lung cancer and its variants: a SEER-based study. J Cancer Res Clin Oncol. 2018; 144(9):1835-1842. DOI: 10.1007/s00432-018-2702-9. View