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Survival Benefit of Surgery Unclear in Lung Cancer

Review neither supports nor discounts improved survival in patients with non-small cell lung cancer

WEDNESDAY, July 26 (HealthDay News) -- In patients with non-small cell lung cancer (NSCLC), the survival benefit of surgery is inconclusive, according to a study published in the July issue of Thorax.

Renee Manser, M.D., of St. Vincent's Hospital in Melbourne, Australia, and colleagues conducted a systematic review and meta-analysis of 11 randomized controlled trials involving 1,910 NSCLC patients.

The researchers found that six trials showed no survival benefit from surgery compared to non-surgical treatment. In a pooled analysis of three trials, they found improved four-year survival among stage I-IIIA NSCLC patients who underwent resection and had complete mediastinal lymph node dissection compared to those who underwent lymph node sampling (hazard ratio, 0.78). In another trial, they found a lower rate of local recurrence in stage I NSCLC patients who underwent lobectomy compared to those who underwent limited resection. They also found one small study that showed a survival advantage in stage IIIA NSCLC patients who underwent chemotherapy followed by surgery compared to those who underwent chemotherapy followed by radiotherapy.

"The current evidence from randomized controlled trials neither supports nor discounts the survival benefit of surgery for NSCLC," the authors conclude. "However, as more extensive (complete) surgery appears superior to less, by inference some surgery might be better than no surgery."

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