Reevaluating the role of surgery in lung cancer with liver metastases: a propensity score-matched survival analysis.

BACKGROUND

Surgery is the main modality of comprehensive tumor treatment, and there are fewer studies on surgery in lung cancer patients with liver metastases.

METHODS

In this study, clinical data on lung cancer patients with liver metastases were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Patients treated with cancer-directed surgery (CDS) by Propensity Score Matching (PSM) are matched 1:1 to patients not treated with CDS. The impact of CDS treatment and clinical factors on patient prognosis was explored Kaplan-Meier survival analysis, univariate and multivariate Cox analysis, and Cox risk proportional regression models.

RESULTS

A total of 6,632 lung cancer patients with liver metastases were included in this study, including 83 patients treated with CDS (1.25%) and 6549 patients not treated with CDS (98.75%). By PSM matching, 83 patients not treated with CDS were obtained. Survival analysis showed that the median survival was 9 months (95% CI 7-15 months) in the CDS group, compared to 3 months (95% CI 2-6 months) in the No-CDS group. Cox risk proportional regression models indicated that No-CDS, male and N2-N3 staging were prognostic risk factors, whereas chemotherapy were prognostic protective factors. In addition, univariate and multivariate Cox analyses showed that No-CDS and men were independent prognostic risk factors, whereas chemotherapy were independent prognostic protective factors.

CONCLUSIONS

Our findings suggest that CDS treatment can improve the prognosis of patients with lung cancer with liver metastases, which will provide a reference for further randomized controlled clinical trials.