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Aggressive Surgery for Patients With Early-Stage Lung Cancer

By: Laura Entis
Posted: Wednesday, January 10, 2018

Patients with early-stage lung cancer who undergo lobectomy appear to have improved survival compared with those who receive stereotactic body radiation therapy (SBRT), according to an analysis of more than 4000 patients in a Veterans Affairs system database. These findings were published by James D. Murphy, MD, MS, of the University of California San Diego, and colleagues in The Annals of Thoracic Surgery.

“Our data suggest that the higher operative risks of surgery are more than offset by improved survival in the months and years after treatment, particularly for lobectomy,” said lead author of the study Alex Bryant, BS, of the School of Medicine at the University of California San Diego in a press release. However, the investigators concluded, prospective randomized trials comparing these treatment modalities further are necessary.

Using data from the Veterans Affairs Informatics and Computing Infrastructure, the researchers identified 4069 patients with biopsy-proven clinical stage I non–small cell lung cancer who were diagnosed between 2006 and 2015. Of these patients, 2986 underwent lobectomy, 634 had sublobar resection, and 449 received SBRT.

Although the 30-day mortality rate was higher with lobectomy than with sublobar resection or radiation treatment (1.9%, 1.7%, and 0.5%, respectively), the 5-year incidence of cancer death was lower for patients who underwent lobectomy (23%) than for those who had sublobar resection (32%) or SBRT (45%).