Patients With Surgically Resectable Lung Cancer Who Opt for Radiation Have Worse Outcomes.

Area of Science:

• Oncology
• Thoracic Surgery
• Radiation Oncology

Background:

• Surgery is the standard treatment for resectable primary lung cancer (LC).
• Stereotactic body radiation therapy (SBRT) is an alternative, but outcome data is biased by patient selection.
• This study compares survival between surgery and radiation for patients eligible for both.

Purpose of the Study:

• To compare survival outcomes for early-stage non-small cell lung cancer (NSCLC) patients who underwent surgical resection versus those who opted for radiation therapy.
• To evaluate the efficacy of SBRT compared to surgery in patients with resectable primary LC.

Main Methods:

• Utilized the Surveillance, Epidemiology, and End Results (SEER) database for Stage I NSCLC patients (2007-2016).
• Excluded patients with unknown surgical recommendation or contraindications.
• Performed multivariate analysis and generated Kaplan-Meier survival curves, adjusting for age, sex, race, insurance, marital status, tumor size, and histology.

Main Results:

• Surgical resection demonstrated significantly greater survival compared to radiation therapy (adjusted HR 2.66, p < 0.001).
• Patients receiving surgery also had better survival than those receiving no standardized treatment (adjusted HR 4.43, p < 0.001).

Conclusions:

• Surgical resection is a superior treatment modality for patients with resectable early-stage lung cancer when compared to radiation therapy.
• SBRT remains an effective option for patients who are inoperable, but comparative data highlights surgery's advantage for eligible candidates.