Treatment Outcomes in Stage I Lung Cancer: A Comparison of Surgery and Stereotactic Body Radiation Therapy

Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
Varun PuriClifford Robinson

Abstract

The relative roles of surgery and stereotactic body radiation therapy in stage I non-small-cell lung cancer (NSCLC) are evolving particularly for marginally operable patients. Because there is limited prospective comparative data for these treatment modalities, we evaluated their relative use and outcomes at the population level using a national database. Patient variables and treatment-related outcomes were abstracted for patients with clinical stage I NSCLC from the National Cancer Database. Patients receiving surgery were compared with those undergoing stereotactic body radiation therapy (SBRT) in exploratory unmatched and subsequent propensity matched analyses. Between 1998 and 2010, 117,618 patients underwent surgery or SBRT for clinical stage I NSCLC. Of these, 111,731 (95%) received surgery, whereas 5887 (5%) underwent SBRT. Patients in the surgery group were younger, more likely to be males, and had higher Charlson comorbidity scores. SBRT patients were more likely to have T1 (versus T2) tumors and receive treatment at academic centers. Thirty-day surgical mortality was 2596 of 109,485 (2.4%). Median overall survival favored the surgery group in both unmatched (68.4 versus 33.3 months, p < 0.001) and matched analysis ba...Continue Reading

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Citations

Jan 31, 2017·Seminars in Cardiothoracic and Vascular Anesthesia·Julissa E Jurado, Brendon Stiles
May 1, 2016·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Michael Poullis
May 1, 2016·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Varun Puri, Clifford G Robinson
Jun 28, 2016·The Journal of Thoracic and Cardiovascular Surgery·Mark W Onaitis, Joseph Salama
May 2, 2016·The Journal of Thoracic and Cardiovascular Surgery·Joshua E RosenDaniel J Boffa
Dec 23, 2016·Expert Review of Respiratory Medicine·Marjolein A HeuvelmansMatthijs Oudkerk
May 4, 2017·The Journal of Thoracic and Cardiovascular Surgery·Babatunde A YerokunMatthew G Hartwig
May 10, 2017·The Journal of Thoracic and Cardiovascular Surgery·Timothy L McMurryBenjamin D Kozower
Jan 13, 2018·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·L YeJ He
Jan 4, 2017·The European Respiratory Journal·Fiona McDonaldPaul E Van Schil
Aug 1, 2020·Respirology : Official Journal of the Asian Pacific Society of Respirology·Alan D L Sihoe
Oct 4, 2017·Journal of Oncology Practice·Jeffrey A Bogart, Jason Wallen
Jul 20, 2017·American Journal of Respiratory and Critical Care Medicine·Nichole T TannerGerard A Silvestri
Mar 29, 2021·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Jelle EversMieke J Aarts
Apr 8, 2019·International Journal of Radiation Oncology, Biology, Physics·Percy LeeX Allen Li
Aug 15, 2021·The Annals of Thoracic Surgery·Brendan T HeidenBenjamin D Kozower

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