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1-, 3-, and 5-year survival among early-stage lung cancer patients treated with lobectomy vs SBRT

Authors Albano D, Bilfinger T, Nemesure B

Received 23 February 2018

Accepted for publication 14 May 2018

Published 24 August 2018 Volume 2018:9 Pages 65—71


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Sai-Hong Ignatius Ou

Denise Albano,1 Thomas Bilfinger,1 Barbara Nemesure2

1Department of Surgery, Health Sciences Center, Stony Brook Medicine, Stony Brook, NY, USA; 2Department of Family, Population and Preventive Medicine, Health Sciences Center, Stony Brook Medicine, Stony Brook, NY, USA

Background: Lobectomy has traditionally been recommended for fit patients diagnosed with early-stage non-small-cell lung cancer (NSCLC). Recently, however, stereotactic body radiotherapy (SBRT) has been introduced as an alternative treatment option. The purpose of this investigation is to compare survival outcomes for individuals with stage I/II NSCLC treated with lobectomy vs SBRT.
Methods: This retrospective study included 191 patients (100 surgery, 91 SBRT) identified through the Lung Cancer Evaluation Center, Stony Brook, NY, between 2008 and 2012. Survival and recurrence rates were compared using Kaplan–Meier curves, log-rank tests, and Cox proportional hazard models to adjust for possible confounders. A subset of cases was propensity-matched to address potential differences in health status between groups.
Results: 1-, 3-, and 5-year survival outcomes were significantly better among patients undergoing lobectomy vs SBRT. Survival rates at 3 years were 92.8% and 59.0% (p<0.001) in the 2 groups, respectively. Propensity-matched analyses indicated similar findings. Recurrence rates were likewise lower among patients undergoing surgery (7.1% vs 21.0%, p<0.01 at 3 years); however, statistical significance was not maintained in the propensity-matched analysis.
Conclusion: These findings add to a growing evidence base supporting the use of lobectomy vs SBRT in the treatment of lung cancer among healthy, early-stage NSCLC patients.

Keywords: SBRT, lobectomy, survival

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