Primary Tumor Resection Improves Survival for EGFR-TKI-Treated Patients With Occult M1a Lung Adenocarcinoma

Area of Science:

• Oncology
• Thoracic Surgery
• Medical Oncology

Background:

• The benefit of primary tumor resection in lung adenocarcinoma with occult M1a pleural dissemination is not well-defined, particularly with targeted therapy.
• Occult pleural dissemination (M1a) represents a specific stage of lung adenocarcinoma with uncertain prognostic factors.

Purpose of the Study:

• To evaluate the impact of primary tumor resection on overall survival (OS) in lung adenocarcinoma patients with occult M1a pleural dissemination who are receiving targeted therapy.
• To determine if surgical intervention improves outcomes in this specific patient subgroup.

Main Methods:

• Retrospective analysis of 34 lung adenocarcinoma patients with intraoperatively-confirmed occult pleural dissemination (M1a) treated with EGFR-TKIs.
• Comparison of overall survival between patients who underwent primary tumor resection and those who did not using log-rank tests.

Main Results:

• Patients undergoing primary tumor resection (20/34) showed significantly prolonged OS compared to those without resection (14/34) (log-rank P=0.042).
• The 2-year and 5-year OS rates for patients with primary tumor resection were 90.0% and 60.1%, respectively.
• No significant baseline differences were observed between the resection and non-resection groups.

Conclusions:

• Primary tumor resection is associated with improved survival in lung adenocarcinoma patients with occult M1a pleural dissemination receiving EGFR-TKIs.
• Surgical management of the primary tumor may be a beneficial strategy for select patients with advanced lung adenocarcinoma and occult pleural spread.