Surgical outcomes of stage IV non-small cell lung cancer: a single-center experience

Abstract

Background: Increasing evidence has shown the effectiveness of surgery for stage IV non-small cell lung cancer (NSCLC). Present study aims to summarize the experience of our institution in dealing with advanced NSCLC in the context of multimodality therapy including lung surgery. Methods: Patients underwent surgical resection for stage IV NSCLC diagnosed before or during surgery from January 2014 to June 2017 at Tangdu Hospital were included in this study. Results: There were 88 stage IV NSCLC patients enrolled in this study. Among them, 35 patients with pleural metastases, 18 with brain oligometastases, 25 with extra-brain oligometastases and 10 with multiple metastatic sites or organs. For primary lung tumor, almost all (86/88) were resected with R0. For metastatic lesions, 53 patients received curative local treatment and 9 patients with partial treatment. There were 62 patients received adjuvant treatment, 10 patients received no adjuvant treatment and 16 patients with missing data of adjuvant treatment. The median overall survival of patients was 31.72 months. The estimated 3-year OS was 42.2%. Patients with pleural metastases and brain oligometastases got better outcomes than the ones with extra-brain oligometastases and multiple metastases (P<0.001). Patients with adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment had significantly better OS compared with those with adjuvant chemotherapy treatment (P=0.015). Besides, age <60 and cT1-2 were also associated with better survival. Conclusions: Surgery may be a considerable choice for stage IV NSCLC in the context of multimodality therapy.

WITHDRAWN: Correlation between DVH parameters and lung function changes before and after radiotherapy and the occurrence of radiation-induced lung injury (RILI)

“…At present, the incidence of lung cancer is showing a rapid upward trend in the world, and the mortality rate ranks rst in malignant tumors in the world [21,22]. Lung cancer has become the rst cause of death from malignant tumors in China, accounting for 22.7% of all malignant tumor deaths [23,24]. Synchronous radiotherapy and chemotherapy for non-small cell lung cancer that is not suitable for surgery has become the current standard treatment mode, and RILI is a common complication of lung cancer radiotherapy [25,26].…”

Evaluation of local aggressive lung therapy versus systemic therapy in oligometastatic non-small cell lung cancer: a systematic review and meta-analysis

“…Pneumonitis and esophagitis are most common adverse event of radiotherapy for about 8-17% patients (16,19). Surgery related complications were reported as 9% in our center for stage IV NSCLC patients (28). This reminds us that candidates for LT should be with tolerance of toxicity after proper selection.…”

Research on the effect of health care integration on patients’ negative emotions and satisfaction with lung cancer nursing activities

“…Lung cancer has a high incidence and mortality[ 11 , 12 ], and the current clinical treatment for patients with lung cancer is surgery[ 13 , 14 ]; even after surgery, patients are prone to recurrence[ 15 ]; therefore, more patients need to be treated with adjuvant chemotherapy to reduce the risk of disease recurrence and ensure the effectiveness of treatment[ 16 ]. However, due to the fear of disease and surgery and the side effects of chemotherapy, patients are prone to self-abdication, and therefore, they receive insufficient treatment[ 17 ], which affects their overall outcome[ 18 ].…”