Ablation Therapy for Advanced Stage Non-Small Cell Lung Cancer: A National Cancer Database Study |
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| Affiliation: | 1. Department of Diagnostic Imaging, Rhode Island Hospital, Providence, Rhode Island;2. Warren Alpert Medical School of Brown University, Providence, Rhode Island;3. Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China;4. Yale School of Medicine, New Haven, Connecticut;5. Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;1. Department of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China;2. Vascular Center of Shanghai Jiao Tong University, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China;1. Department of Radiology, Mayo Clinic, 200 First Street SW, Mayo 2 West, Rochester, MN, 55901;2. Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada;3. Baylor University Medical Center, Dallas, Texas;4. California Pacific Medical Center, San Francisco, California;5. Virginia Commonwealth University, Richmond, Virginia;6. Sequana Medical AG, Zurich, Switzerland;8. Division of Interventional Radiology, University of Virginia School of Medicine, Charlottesville, Virginia;1. Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan;2. Gastroenterological Surgery, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan;3. General Thoracic Surgery, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan;1. Department of Biochemistry and Structural Biology, Instituto de Fisiologa Celular, Universidad Nacional Autónoma de México, México D. F., México;2. Centro de Investigación Científica y de Educación Superior de Ensenada, México |
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| Abstract: | PurposeTo compare overall survival (OS) of ablation with no treatment for patients with advanced stage non-small cell lung cancer.MethodsPatients with clinical stage IIIB (T1–4N3M0, T4N2M0) and stage IV (T1–4N0–3M1) 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.ResultsA 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.ConclusionsPreliminary 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. |
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