mNSCLC: surgery rare, but improves OS in extrathoracic disease

  • Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Primary tumor resection for stage IV extrathoracic metastatic NSCLC (mNSCLC) is associated with significant improvement in OS.
  •  recommended for surgical intervention.

Why this matters

  • Although surgery is a recommended treatment for stage IV extrathoracic metastatic NSCLC, the actual surgical rate remains low.

Study design

  • 39,655 patients with extrathoracic mNSCLC from the Surveillance, Epidemiology, and End Results database.
  • Funding: None disclosed.

Key results

  • Overall, surgery was recommended for 4.8% of patients, but only 3.0% underwent resection.
  • Patients with brain metastases had the highest rate of surgery (5.5%), followed by those with liver metastases (2.4%), bone metastases (2.1%), and multiorgan metastases (1.2%).
  • Surgical patients had significantly longer median OS than patients who did not have surgery, both before propensity score matching (14 vs 6 months; P<.001 and after vs months p>
  • After multivariable analysis, primary tumor resection was independently associated with improved OS (aHR, 0.60; 95% CI, 0.56-0.64) and lung cancer-specific mortality (subHR, 0.61; 95% CI, 0.57-0.66) in the overall cohort and in those recommended for surgery (aHR, 0.62 [95% CI, 0.55-0.70]; SHR, 0.64 [95% CI, 0.57-0.73], respectively).

Limitations

  • Retrospective study.

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