Background. There is currently limited evidence for a correlation between the recommended operation and overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC). Methods. NSCLC patients with stages III and IV, recommended for operation, were identified in the US National Cancer Institute Surveillance, Epidemiology, and End Results database (SEER).We used propensity score matching (PSM) and multivariable Cox proportional hazards regression to ensure the robustness of our findings. The cumulative rates of death were compared between patients with and without recommended operations using the Kaplan−Meier curves. Results. Operation was recommended for 3331 patients but was not performed in 912 (27.4%) patients (then on-operative group). After PSM, 553 pairs matched. Compared to the nonoperative group, the hazard ratios (HRs) in the operative group were 0.46 (95% CI 0.23–0.95 and ) in stage IIIA and 0.54 (95% CI 0.42–0.68 and ) in stage IVA. However, in stages IIIB, IIIC, and IVB, the recommended operative group was not associated with better OS. The OS was not different in stage IIIA-N2, stage IVA-N1, and stage IVA-N3 patients between groups (, , and , respectively). Moreover, the recommended operative group had better OS than the nonoperative group in stage IIIA-N0 (), stage IIIA-N1 (), stage IVA-N0 (), and stage IVA-N2 (). Conclusion. Compared to the nonoperative group, recommended operation improved survival in NSCLC patients with stage IIIA-N0, stage IIIA-N1, stage IVA-N0, and stage IVA-N2. However, in stages IIIA-N2, IIIB, IIIC, IVA-N1, IVA-N3, and IVB, recommended operation did not lead to significantly improved survival time.

中文翻译：

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晚期非小细胞肺癌患者的手术治疗与非手术治疗：建议手术

背景。目前，有限的证据表明推荐的手术与晚期非小细胞肺癌（NSCLC）患者的总生存期（OS）之间存在相关性。方法。推荐手术的III期和IV期NSCLC患者均在美国国家癌症研究所监测、流行病学和最终结果数据库（SEER）中确定。我们使用倾向评分匹配（PSM）和多变量Cox比例风险回归来确保稳健性我们的发现。使用 Kaplan-Meier 曲线比较接受和未接受推荐手术的患者的累积死亡率。结果。3331 例患者被建议手术，但 912 例（27.4%）患者（当时手术组）未进行手术。PSM 后，有 553 对匹配。与非手术组相比，手术组的风险比 (HR) 为 0.46（95% CI 0.23-0.95，）在 IIIA 期和 0.54（95% CI 0.42–0.68 和）在IVA阶段。然而，在 IIIB、IIIC 和 IVB 期，推荐的手术组与更好的 OS 无关。IIIA-N2 期、IVA-N1 期和 IVA-N3 期患者组之间的 OS 没有差异（, ，和，分别）。此外，推荐的手术组在 IIIA-N0 期的 OS 优于非手术组（）， IIIA-N1 期（）， IVA-N0 阶段（）和 IVA-N2 期（）。 结论。与非手术组相比，推荐的手术改善了 IIIA-N0 期、IIIA-N1 期、IVA-N0 期和 IVA-N2 期 NSCLC 患者的生存率。然而，在IIIA-N2、IIIB、IIIC、IVA-N1、IVA-N3和IVB期，推荐的手术并没有导致生存时间的显着改善。