P2.01-53 Surgical Resection of Primary Tumor Improve the Prognosis of Lung Cancer Patients with Bone Metastasis

Abstract

Most of the lung cancer patients are in advanced stage at the time of diagnosis due to occult onset. Bone metastasis is one of the most common sites of hematogenous metastasis of lung cancer. This study used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the impact of surgical resection of primary tumor on the prognosis of lung cancer patients with bone metastasis. We identified 12578 lung patients with only bone metastasis from the Surveillance, Epidemiology, and End Results database. Propensity score matching was used to reduce the selection bias. Cancer–specific survival (CSS) were compared between patients with or without primary tumor resection. The Cox regression model was applied to evaluate multiple prognostic factors. The effects of different surgical extension and lymph node resection on prognosis were also analyzed. After propensity matching, a total of 458 patients were selected into survival analysis. There were no statistical differences in age, gender, race, tumor location, histology, T stage and N stage between patients with or without surgical resection of primary tumor. The prognosis of patients undergoing surgical resection of primary tumor was significantly better than that of patients who had not undergone surgery (five-year CSS rate: 2.7% vs. 23.4%, respectively, P<0.001). Multivariable analysis revealed that surgical resection of primary tumor was an independent prognostic factor (HR=0.518, 95% confidence interval [CI] 0.414 to 0.648, P<0.001). In addition, the prognosis of patients undergoing lobectomy/bilobectomy was significantly better than that of others(P<0.001). Furthermore, regional lymph node resection during the operation could significantly improve the prognosis of the patients (P<0.001). For lung cancer patients with only bone metastasis, surgical resection of primary tumor could significantly improve the prognosis. Lobectomy/bilobectomy with regional lymph node resection was the best surgical strategy.