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Survival after thermal ablation versus wedge resection for stage I non-small cell lung cancer < 1 cm and 1 to 2 cm: evidence from the US SEER database

  • 0Division of Chest Surgery, Department of Surgery, Cathay General Hospital, No. 280, Sec. 4, Renai Road, Daan District, Taipei, 106, Taiwan.
Cancer Imaging : the Official Publication of the International Cancer Imaging Society +

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July 11, 2024

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July 11, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

For early-stage non-small cell lung cancer (NSCLC) tumors smaller than 1 cm, thermal ablation offers similar survival outcomes to wedge resection. Larger tumors (1-2 cm) showed a higher risk of poor overall survival with thermal ablation compared to wedge resection.

Area Of Science

  • Oncology
  • Thoracic Surgery
  • Cancer Research

Background

  • Stage I non-small cell lung cancer (NSCLC) presents treatment challenges for small tumors.
  • Comparing thermal ablation and wedge resection is crucial for optimizing survival outcomes.

Purpose Of The Study

  • To compare overall survival (OS) and cancer-specific survival (CSS) between thermal ablation and wedge resection for stage I NSCLC ≤ 2 cm.
  • To evaluate the impact of tumor size on treatment efficacy.

Main Methods

  • Retrospective analysis of the US National Cancer Institute SEER database (2004-2019).
  • Inclusion of patients with stage I NSCLC (≤ 2 cm) treated with thermal ablation or wedge resection, excluding those receiving chemotherapy/radiotherapy.
  • Propensity-score matching (PSM) to balance baseline characteristics.

Main Results

  • After PSM, 328 patients were analyzed. Thermal ablation was associated with a higher risk of poor OS (aHR: 1.34) but not CSS compared to wedge resection.
  • Stratified analyses showed no significant differences in OS or CSS between procedures for any histology or grade.
  • For tumors 1-2 cm, thermal ablation correlated with a higher risk of poor OS (aHR: 1.35); however, no significant differences were found for tumors < 1 cm.

Conclusions

  • Thermal ablation demonstrates comparable OS and CSS to wedge resection in patients with stage I NSCLC and tumor size < 1 cm.
  • For stage I NSCLC tumors between 1-2 cm, wedge resection may offer better overall survival outcomes than thermal ablation.

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