Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Thorac Cancer. 2022 May;13(9):1349-1360. doi: 10.1111/1759-7714.14398. Epub 2022 Mar 31.
Local treatment (LT) such as radiotherapy and metastasectomy on metastatic sites may improve outcomes in oligometastatic NSCLC patients, but more data are necessary to support LT in oligometastatic diseases. Patients with single extrathoracic metastatic lesion are more likely to benefit from local therapy. In this study, we evaluated the impact of LT in NSCLC patients with a single extrathoracic metastatic lesion.
Data were obtained from the Korean Association for Lung Cancer Registry (KALC-R), a database created using a retrospective sampling survey by the Korean Central Cancer Registry (KCCR) and the Lung Cancer Registration Committee.
A total of 787 NSCLC patients with a single extrathoracic metastatic lesion were evaluated. In the multivariate analysis for OS, age, female sex, poor performance score, squamous histological subtype, LT, and initial treatment modality showed significant associations. Regarding LT, groups that underwent curative LT were significantly associated with better OS compared to groups that did not undergo LT (p = 0.011, HR 0.448, 95% CI: 0.242-0.829). In the multivariate analysis of patients who underwent LT, poor performance score, initial treatment modality, and T stage were independently associated with poor OS. Compared to the T1 stage, T3 stage showed an HR of 2.470 (95% CI: 1.309-4.663; p = 0.005) and T4 stage showed an HR of 2.063 (95% CI: 1.093-3.904; p = 0.026).
In NSCLC with a single extrathoracic metastatic lesion, LT, especially for curative purposes, has an independent association with OS. Moreover, among the patients who received LT, factors such as T stage, poor performance score, and initial treatment modality were significantly associated with OS.
局部治疗（LT），如转移性部位的放疗和转移灶切除术，可能改善寡转移性非小细胞肺癌（NSCLC）患者的预后，但需要更多数据来支持寡转移疾病的 LT。仅有单一胸外转移病灶的患者更有可能从局部治疗中获益。在这项研究中，我们评估了 LT 对仅有单一胸外转移病灶的 NSCLC 患者的影响。
数据来自韩国肺癌登记处（KALC-R），该数据库是通过韩国中央癌症登记处（KCCR）和肺癌登记委员会进行回顾性抽样调查创建的。
共评估了 787 例仅有单一胸外转移病灶的 NSCLC 患者。在 OS 的多变量分析中，年龄、女性、较差的表现评分、鳞癌组织学亚型、LT 和初始治疗方式与结果显著相关。关于 LT，接受根治性 LT 的组与未接受 LT 的组相比，OS 显著延长（p=0.011，HR 0.448，95%CI：0.242-0.829）。在接受 LT 的患者的多变量分析中，较差的表现评分、初始治疗方式和 T 分期与较差的 OS 独立相关。与 T1 期相比，T3 期的 HR 为 2.470（95%CI：1.309-4.663；p=0.005），T4 期的 HR 为 2.063（95%CI：1.093-3.904；p=0.026）。
在仅有单一胸外转移病灶的 NSCLC 中，LT，特别是根治性 LT，与 OS 有独立关联。此外，在接受 LT 的患者中，T 分期、表现评分差和初始治疗方式等因素与 OS 显著相关。
