Abstract
BACKGROUND: Surgery is the main modality of comprehensive tumor treatment, and there are fewer studies on surgery in lung cancer patients with liver metastases. METHODS: In this study, clinical data on lung cancer patients with liver metastases were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Patients treated with cancer-directed surgery (CDS) by Propensity Score Matching (PSM) are matched 1:1 to patients not treated with CDS. The impact of CDS treatment and clinical factors on patient prognosis was explored Kaplan-Meier survival analysis, univariate and multivariate Cox analysis, and Cox risk proportional regression models. RESULTS: A total of 6,632 lung cancer patients with liver metastases were included in this study, including 83 patients treated with CDS (1.25%) and 6549 patients not treated with CDS (98.75%). By PSM matching, 83 patients not treated with CDS were obtained. Survival analysis showed that the median survival was 9 months (95% CI 7-15 months) in the CDS group, compared to 3 months (95% CI 2-6 months) in the No-CDS group. Cox risk proportional regression models indicated that No-CDS, male and N2-N3 staging were prognostic risk factors, whereas chemotherapy were prognostic protective factors. In addition, univariate and multivariate Cox analyses showed that No-CDS and men were independent prognostic risk factors, whereas chemotherapy were independent prognostic protective factors. CONCLUSIONS: Our findings suggest that CDS treatment can improve the prognosis of patients with lung cancer with liver metastases, which will provide a reference for further randomized controlled clinical trials.