Effect Of Local Intervention On Prognosis Of Extracranial Oligometastases In Non-small Cell Lung Cancer

[Objective]To explore the effect of local intervention on the prognosis of NSCLC extracranial oligometastases in the real world and to find clinical features related to prognosis.[Contents]Retrospective analysis of 101 patients who first discovered and systematically treated extracranial oligometastases of NSCLC in the First Affiliated Hospital of Suzhou University from September 2010 to December 2015.The patients were divided into group A(systemic treatment group)and group B(systemic combined with local treatment group)according to the treatment mode of metastases.At the same time,the patients were divided into different subgroups according to the pathological type of primary tumor and the EGFR gene mutation status in specific pathological type.The patient's overall survival(OS)and the clinical features were observed.Kaplan-Meier method was used to analyze OS and the survival curve was drawn.Log-rank method was used to compare the overall survival between group A and B.The COX multivariate model was used to analyze the effects of various clinical features on OS.[Results]Among the 101 patients with NSCLC,the median follow-up time was 24.96 months(6.74?97.54 months),the median survival time was 25.10 months.The median OS of group A was 22.14 months,and the median OS of group B was 33.54 months.statistical difference was found in the OS between the two groups(P=0.003).In the subgroup analysis:The median OS of adenocarcinoma in group A was 21.88 months,and the median OS of adenocarcinoma in group B was 38.24 months,statistical difference was found in the OS between the two groups(P=0.002).The median OS of squamous cell carcinoma in group A was 22.60 months and 24.14 months in group B,no statistical difference was found in the OS between the two groups(P=0.470).The median OS of EGFR gene wild type patients in adenocarcinoma in group A was 19.02 months and 27.57 months in group B,statistical difference was found in the OS between the two groups(P=0.039).The median OS of the EGFR gene mutation in adenocarcinoma in group A was 32.49 months and 61.73 months in group B,no statistical difference was found in the OS between the two groups(P=0.058).Multivariate analysis of clinical features showed that tissue differentiation,EGFR gene mutation status,regional lymph node metastasis status,number of metastatic organs,and local intervention of metastases were independent influencing factors of OS.[Conclusion]1.Local intervention based on systemic therapy of extracranial oligometastases in patients with NSCLC can significantly improve overall survival.Especially in patients with adenocarcinoma and with wild-type EGFR genes in adenocarcinoma,the local intervention of metastases can bring better survival benefits.2.In patients of extracranial oligometastatic NSCLC,poor tissue differentiation,EGFR gene wild type,N2 and above regional lymph node metastases,multiple organs metastases,no local intervention in metastases are independent risk factors affecting the overall survival.