Wedge Resection versus Stereotactic Body Radiation Therapy for Non-Small Cell Lung Cancer Tumors ≤8 mm

Area of Science:

• Oncology
• Thoracic Surgery
• Radiation Oncology

Background:

• Early-stage non-small cell lung cancer (NSCLC) requires effective treatment strategies.
• Comparing surgical resection with radiation therapy is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare overall survival between wedge resection and stereotactic body radiation therapy (SBRT) for small (≤8 mm) NSCLC.
• To analyze treatment efficacy in a large patient cohort using real-world data.

Main Methods:

• Retrospective analysis of the National Cancer Database (NCDB) from 2004-2017.
• Kaplan-Meier analysis, multivariable Cox modeling, and propensity score-matched analysis were employed.
• Exclusion criteria included prior malignancy and contraindications for surgery.

Main Results:

• Wedge resection was associated with improved overall survival compared to SBRT in unadjusted and adjusted analyses.
• Propensity score-matched analysis confirmed the survival benefit of wedge resection.
• Sensitivity analysis in patients with no comorbidities yielded consistent results favoring wedge resection.

Conclusions:

• Wedge resection appears to be a superior treatment option for overall survival in patients with small NSCLC (≤8 mm).
• These findings support surgical intervention for early-stage NSCLC when feasible.
• Further prospective studies may be warranted to confirm these outcomes.