- Surgical resection of the primary tumor had significantly better OS and lung cancer-specific mortality (LCSM) in patients with NSCLC with ipsilateral pleural dissemination, except those with pericardial effusion or N3 disease.
Why this matters
- NSCLC with pleural dissemination was reclassified as stage IV (M1a) in the 2017 Union for International Cancer Control lung cancer staging system, and surgical resection was contraindicated.
- 5513 patients with stage IV M1a (malignant pleural dissemination) NSCLC from the Surveillance, Epidemiology and End Results database.
- Funding: None disclosed.
- 5.6% of the overall cohort underwent resection.
- Surgical patients had significantly longer OS than nonsurgical patients in the unmatched (20 vs 8 months; P<.001 and matched vs months p cohorts.>
- Among patients recommended for surgery, those who underwent resection had significantly better OS than those who did not in the unmatched (20 vs 5 months; P<.001 and matched vs months p=".022)" cohorts.>
- After multivariable analysis, primary tumor resection was independently associated with improved OS (HR, 0.56; P<.001 and lcsm p>
- Surgery was an independent predictor of LCSM in all subgroups except patients with pericardial effusion (P=.065) or N3 disease (P=.17).
- No data on performance status or comorbidities.