Objective

To investigate the survival benefit of preoperative bone scan in asymptomatic patients with early-stage non-small cell lung cancer (NSCLC).

Methods

This retrospective study included patients with radical resection for stage T1N0M0 NSCLC between March 2013 and December 2018. During postoperative follow-up, we monitored patient survival and the development of bone metastasis. We compared overall survival, bone metastasis-free survival, and recurrence-free survival in patients with or without preoperative bone scan. Propensity score matching and inverse probability of treatment weighting were used to minimize election bias.

Results

A total of 868 patients (58.19 ± 9.69 years; 415 men) were included in the study. Of 87.7% (761 of 868) underwent preoperative bone scan. In the multivariable analyses, bone scan did not improve overall survival (hazard ratio [HR] 1.49; 95% confidence intervals [CI] 0.91–2.42; p = 0.113), bone metastasis-free survival (HR 1.18; 95% CI 0.73–1.90; p = 0.551), and recurrence-free survival (HR 0.89; 95% CI 0.58–1.39; p = 0.618). Similar results were obtained after propensity score matching (overall survival [HR 1.28; 95% CI 0.74–2.23; p = 0.379], bone metastasis-free survival [HR 1.00; 95% CI 0.58–1.72; p = 0.997], and recurrence-free survival [HR 0.76; 95% CI 0.46–1.24; p = 0.270]) and inverse probability of treatment weighting.

Conclusion

There were no significant differences in overall survival, bone metastasis-free survival, and recurrence-free survival between asymptomatic patients with clinical stage IA NSCLC with or without preoperative bone scan.

中文翻译：

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分期骨扫描对 IA 期非小细胞肺癌患者的预后没有影响

客观的

探讨术前骨扫描对无症状早期非小细胞肺癌（NSCLC）患者的生存益处。

方法

这项回顾性研究纳入了 2013 年 3 月至 2018 年 12 月期间接受根治性切除的 T1N0M0 期 NSCLC 患者。在术后随访期间，我们监测了患者的生存情况和骨转移的发展情况。我们比较了术前进行或未进行骨扫描的患者的总生存率、无骨转移生存率和无复发生存率。使用倾向得分匹配和治疗加权的逆概率来最小化选举偏差。

结果

该研究共纳入 868 名患者（58.19 ± 9.69 岁；415 名男性）。 87.7%（868 人中的 761 人）接受了术前骨扫描。在多变量分析中，骨扫描并未改善总生存率（风险比 [HR] 1.49；95% 置信区间 [CI] 0.91–2.42；p  = 0.113）、无骨转移生存率（HR 1.18；95% CI 0.73– 1.90；p  = 0.551）和无复发生存率（HR 0.89；95% CI 0.58–1.39；p  = 0.618）。倾向评分匹配后获得了类似的结果（总生存期[HR 1.28；95% CI 0.74–2.23；p  = 0.379]、无骨转移生存期[HR 1.00；95% CI 0.58–1.72；p  = 0.997]和复发率） -无生存率[HR 0.76；95% CI 0.46–1.24；p  = 0.270]）和治疗权重的逆概率。

结论

有或没有术前骨扫描的临床 IA 期 NSCLC 无症状患者的总生存期、无骨转移生存期和无复发生存期没有显着差异。