Lobectomy Beats SBRT Survival in Early-Stage NSCLC
Higher cancer mortality for SBRT versus lobectomy; no difference for SBRT, sublobar resection
FRIDAY, Dec. 1, 2017 (HealthDay News) -- For stage I non-small-cell lung cancer, survival is better with lobectomy than stereotactic body radiation therapy (SBRT), although there is no difference for sublobar resection and SBRT, according to a study published online Nov. 29 in the Annals of Thoracic Surgery.
Alex K. Bryant, from the University of California San Diego in La Jolla, and colleagues compared cancer-specific survival among patients with biopsy-proven clinical stage I non-small-cell lung cancer receiving lobectomy, sublobar resection, or SBRT. Data were included for 4,069 patients (449 SBRT, 2,986 lobectomy, and 634 sublobar resection).
The researchers found that immediate post-procedural mortality was higher in the surgery groups than the SBRT group in unadjusted analysis. After adjustment for confounders, including preoperative pulmonary function, smoking status, comorbidity, and staging work-up procedures, the analysis considering long-term survival found higher cancer-specific mortality for SBRT than lobectomy (subdistribution hazard ratio, 1.45; 95 percent confidence interval, 1.09 to 1.94; P = 0.01), but no significant difference between SBRT and sublobar resection (subdistribution hazard ratio, 1.25; 95 percent confidence interval, 0.93 to 1.68; P = 0.15).
"Among a large cohort of early-stage lung cancer patients, we found that lobectomy had improved survival compared with SBRT, although we found no survival difference between sublobar resection and SBRT," the authors write.