Purpose

To compare overall survival (OS) of ablation with no treatment for patients with advanced stage non-small cell lung cancer.

Methods

Patients with clinical stage IIIB (T_1–4N₃M₀, T₄N₂M₀) and stage IV (T_1–4N_0–3M₁) non-small cell lung cancer, in accordance with the American Joint Committee on Cancer, 7th edition, who did not receive treatment or who received ablation as their sole primary treatment besides chemotherapy from 2004 to 2014, were identified from the National Cancer Data Base. OS was estimated using the Kaplan-Meier method and evaluated by log-rank test, univariate and multivariate Cox proportional hazard regression, and propensity score-matched analysis. Relative survival analyses comparing age- and sex-matched United States populations were performed.

Results

A total of 140,819 patients were included. The 1-, 2-, 3- and 5-year survival rates relative to age- and sex-matched United States population were 28%, 18%, 12%, and 10%, respectively, for ablation (n = 249); and 30%, 15%, 9%, and 5%, respectively for no treatment (n = 140,570). Propensity score matching resulted in 249 patients in the ablation group versus 498 patients in the no-treatment group. After matching, ablation was associated with longer OS than that in the no-treatment group (median, 5.9 vs 4.7 months, respectively; hazard ratio, 0.844; 95% confidence interval, 0.719–0.990; P = .037). These results persisted in patients with an initial tumor size of ≤3 cm.

Conclusions

Preliminary results suggest ablation may be associated with longer OS in patients with late-stage non-small cell lung cancer than survival in those who received no treatment.

中文翻译：

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晚期非小细胞肺癌的消融治疗：美国国家癌症数据库研究。

目的

比较晚期非小细胞肺癌患者未经治疗的消融总生存期（OS）。

方法

临床IIIB期（T _1–4 N ₃ M ₀，T ₄ N ₂ M ₀）和IV期（T _1–4 N _0–3 M ₁）的患者）根据美国癌症联合委员会第七版的规定，从2004年至2014年除化疗之外未接受任何治疗或仅接受消融作为其主要主要治疗方法的非小细胞肺癌是从美国国家癌症数据库中识别出来的。使用Kaplan-Meier方法估计OS，并通过对数秩检验，单变量和多变量Cox比例风险回归以及倾向得分匹配分析进行评估。进行了相对生存分析，比较了年龄和性别匹配的美国人群。

结果

总共包括140,819名患者。相对于年龄和性别匹配的美国人群，消融的1年，2年，3年和5年生存率分别为28％，18％，12％和10％（n = 249）；未经治疗分别为30％，15％，9％和5％（n = 140,570）。倾向得分匹配导致消融组249例，未治疗组498例。匹配后，消融与比无治疗组的OS更长（中位分别为5.9个月和4.7个月；危险比为0.844； 95％置信区间为0.719-0.990；P  = .037 ）。这些结果持续存在于初始肿瘤尺寸≤3cm的患者中。

结论

初步结果表明，与未接受治疗的患者相比，晚期非小细胞肺癌患者的消融可能与更长的OS有关。