title: Surgical treatment of stage IV non-small cell lung cancer.
abstract: Most stage IV non-small-cell lung cancer (NSCLC) patients are not amenable to curative treatment. The purpose of this study was to analyse our initial experience with an aggressive surgical strategy for stage IV NSCLC, and to define which patients can benefit from this treatment. Forty-six stage IV NSCLC patients who underwent surgical resection of both primary lung cancer and metastatic sites from April 1989 to December 2010 were included in this study. The record of each patient was reviewed for age, gender, pN status, sites of metastasis, histology, surgical procedure and duration of survival. There were 13 females and 33 males. Their median age was 62.0 years (range, 44-82 years). The overall 5-year survival rate was 23.3% (median, 20.0 months), and the disease-free survival rate was 15.8% at 5 years (median, 16.1 months). Patients with the pN2 status had a significantly worse survival than patients with a pN0 or pN1 status (8.6 versus 33.1%, P = 0.0497). According to a multivariate Cox proportional hazards analysis, no independent predictor of survival was identified. The results of our study suggest that surgical treatment can extend the survival in stage IV NSCLC patients if the patients can tolerate surgery.
authors.affiliation: Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, 1-8-1 Jigyo, Fukuoka 810-8563, Japan. daigo-k9@yf7.so-net.ne.jp
authors.forename: Daigo
authors.initials: D
authors.lastname: Kawano
authors.forename: Sadanori
authors.initials: S
authors.lastname: Takeo
authors.forename: Masakazu
authors.initials: M
authors.lastname: Katsura
authors.forename: Shuichi
authors.initials: S
authors.lastname: Tsukamoto
authors.forename: Eri
authors.initials: E
authors.lastname: Masuyama
authors.forename: Yu
authors.initials: Y
authors.lastname: Nakaji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D059146:Metastasectomy / Q000009:adverse effects / Q000401:mortality; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D018579:Patient Selection; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome