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Updated: Sep 9, 2025
06:46
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
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Synchronous Primary Early-Stage Non-Small Cell Lung Cancer: Trends in Management and Factors Associated With Improved
Whitney S Brandt1, Nikki E Rossetti1, Daniel B Eaton2
1Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri.
The Annals of Thoracic Surgery
|September 4, 2025
Summary
Outcomes for synchronous primary early-stage-I non-small cell lung cancer (SPELC) vary by treatment. Surgery-surgery offers the best disease-free survival, while surgery-SBRT and surgery-surgery show similar overall survival in Veterans.
Area of Science:
- Thoracic Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Outcomes for synchronous primary early-stage-I non-small cell lung cancer (SPELC) treated with curative intent are not well understood.
- Multi-modality treatment approaches are common, but comparative effectiveness is unclear.
Purpose of the Study:
- To evaluate treatment utilization and survival outcomes for SPELC patients.
- To compare overall survival (OS) and disease-free survival (DFS) based on treatment modality.
Main Methods:
- Retrospective analysis of 835 Veterans with stage I SPELC from 2006-2024.
- Treatment groups included stereotactic body radiotherapy-SBRT, SBRT-surgery, and surgery-surgery.
- Cox proportional hazard models assessed factors associated with OS and DFS.
Main Results:
- Stereotactic body radiotherapy (SBRT) was used more in older patients with comorbidities.
- Five-year OS: 51.7% (SBRT-SBRT), 72% (SBRT-Surgery), 66.7% (Surgery-Surgery).
- Five-year DFS: 42.7% (SBRT-SBRT), 42.6% (SBRT-Surgery), 57.26% (Surgery-Surgery). SBRT-SBRT and SBRT-Surgery had inferior DFS.
Conclusions:
- Treatment modality significantly impacts outcomes in Veterans with stage I SPELC.
- Surgery-surgery provided superior DFS, while OS was similar between surgery-surgery and SBRT-surgery groups.
- Patient selection and treatment strategy are crucial for optimizing SPELC outcomes.
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