Comparison of the outcomes of sublobar resection and stereotactic body radiotherapy for stage T1-2N0M0 non-small cell lung cancer with tumor size ≤ 5 cm: a propensity score matching analysis

Dong, Baiqiang; Zhu, Xuan; Jin, Jiyuan; Chen, Yuanyuan; Ying, Hangjie; Yamei, Chen; Fj, Lu; Shen, Wei; Wang, Jin; Chen, Ming

doi:10.21037/jtd-20-2367

Cited by 6 publications

(7 citation statements)

References 31 publications

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“…Lung segmentectomy could be interesting in order to spare lung tissue without compromising long-term survival for suspected or diagnosed NSCLC. For non-operated patients, non-ablative treatment, as cryoablation, radiofrequency ablation, microwave ablation, stereotaxic body radiation, percutaneous ablation, are proposed as an interesting therapy [80,81,155,156]. Rather than comparing ablative surgery and non-ablative treatment, surgery and treatment could be combined with the objective of sparing lung tissue in patients with T4 or M1a lung nodules, who could be diagnosed with other NSCLC.…”

Section: Hybrid Surgical Approach or Local Treatment "Thinking Green Surgery"mentioning

confidence: 99%

The Role of Surgery in Lung Cancer Treatment: Present Indications and Future Perspectives—State of the Art

Montagne

Guisier

Vénissac

et al. 2021

Cancers

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Non-small cell lung cancers (NSCLC) are different today, due to the increased use of screening programs and of innovative systemic therapies, leading to the diagnosis of earlier and pre-invasive tumors, and of more advanced and controlled metastatic tumors. Surgery for NSCLC remains the cornerstone treatment when it can be performed. The role of surgery and surgeons has also evolved because surgeons not only perform the initial curative lung cancer resection but they also accompany and follow-up patients from pre-operative rehabilitation, to treatment for recurrences. Surgery is personalized, according to cancer characteristics, including cancer extensions, from pre-invasive and local tumors to locally advanced, metastatic disease, or residual disease after medical treatment, anticipating recurrences, and patients’ characteristics. Surgical management is constantly evolving to offer the best oncologic resection adapted to each NSCLC stage. Today, NSCLC can be considered as a chronic disease and surgery is a valuable tool for the diagnosis and treatment of recurrences, and in palliative conditions to relieve dyspnea and improve patients’ comfort.

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Section: Hybrid Surgical Approach or Local Treatment "Thinking Green Surgery"mentioning

confidence: 99%

The Role of Surgery in Lung Cancer Treatment: Present Indications and Future Perspectives—State of the Art

Montagne

Guisier

Vénissac

et al. 2021

Cancers

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“…For DFS, RFS or PFS, we included twelve relative studies in our meta-analysis (15,18,21,22,24,25,30,31,37,44,45,47). Eight studies de ned DFS, RFS or PFS as the time from treatment procedure until tumor recurrence or death (15,18,21,22,31,44,45,47), showing superior outcomes after surgery (matched studies: HR, 0.60;95% CI, 0.46-0.79; P=0.000; Figure E3, B). Three studies de ned RFS or PFS as the time from the rst day of diagnosis to the date of tumor recurrence (25,30,37), but the pooled outcome of matched studies demonstrated no signi cantly difference between SBRT and surgery (HR, 0.61;95% CI, 0.34-1.08; P=0.091; Figure E3, B).…”

Section: Primary Analysis: Results Of Survival Outcomes Of Surgery Versus Sbrtmentioning

confidence: 99%

Stereotactic body radiation therapy versus surgery for patients with early-stage non–small cell lung cancer( ≤ 5cm): A systematic review and meta-analysis

Zhou

Wen

et al. 2021

Preprint

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Background: Stereotactic body radiation therapy (SBRT) is considered as the preferred treatment method for inoperable early-stage non-small cell lung cancer (NSCLC). However, there is still a debate on the efficacy of SBRT and surgery. This meta-analysis aimed to compare survival outcomes of SBRT and surgery for early-stage NSCLC (≤5cm).Methods: A systematic review and meta-analysis were performed to compare survival outcomes of surgery and SBRT. And the pooled analysis was conducted with STATA 14.0 software. Results: Thirty-nine comparative studies were included for systematic review and twenty-eight of which for quantitative analysis. Compared with SBRT, overall survival (OS) was superior after surgical resection, included lobectomy, sublobar resection, video-assisted thoracoscopic surgery, and thoracotomy, for patients with early-stage NSCLC (≤5cm). And the results of subgroup analysis remained the support of surgery except for the OS of operable matched cohorts and the one matched cohort of age ≥75. However, the HR of OS showed a reduction from patients with unspecific age, ≥65 to ≥75 years old and histopathologically confirmed NSCLC to clinical NSCLC. Although cancer-specific survival and local control was superior after surgery, the recurrence rate of tumors, locoregional control, distant control, and regional control of matched patients demonstrated no significantly different outcomes between SBRT and surgery for early-stage NSCLC.Conclusions: Results show that surgery has superior OS, CSS and local control compared to SBRT for early-stage NSCLC. There is still necessary to explore the survival difference between SBRT and surgery for patients with different characteristics by large-sample, long-term follow-up randomized clinical studies.

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“…For NSCLC patients with local recurrence in the lung after radical surgical treatment, surgery and SBRT are both optional treatments according to the treatment of primary NSCLC [1][2][3]. However, when a local disease progresses to a systemic disease, local treatment is usually considered to have limited bene ts.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that SBRT and surgery show no signi cant difference in e cacy. Furthermore, compared with surgery, SBRT is better tolerated [1][2][3]. However, in clinical practice, most patients choose surgery, and 3-10% of patients have recurrent lung lesions after radical surgery [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Treatment of lung recurrence after radical resection of non-small cell lung cancer: a single-center retrospective analysis using body stereotactic radiotherapy vs. reoperation

Wu¹,

Dong²,

Jin³

et al. 2021

Preprint

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Purpose After radical surgery for non-small cell lung cancer (NSCLC) patients, 3-10% of patients have recurrent lung lesions. For these patients, stereotactic body radiation therapy (SBRT) and recurrence surgery are optional treatments. This study aimed to compare the efficacy of SBRT and surgery in treating lung recurrence after radical NSCLC. Methods A retrospective analysis of NSCLC patients who had undergone radical surgery at the Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) from November 2012 to December 2018 and had received SBRT or reoperation because of postoperative lung recurrence was performed. The Kaplan–Meier method was used to calculate the survival rates, and the log-rank test was used to compare groups. Cox regression was used for univariate and multivariate analysis. Results Among 62 eligible patients, 33 received SBRT and 29 received reoperation. The median follow-up times of the two patient groups were 45.8 months and 37.4 months. The 3-year locoregional control rate (LRCR) of SBRT and surgical patients was 79.8% vs. 90.2% (P=0.936); progression-free survival (PFS) was 58.5% vs. 42.3% (P=0.072); and overall survival (OS) was 78.0% vs. 85.5% (P=0.714). Multivariate analysis suggested that the treatment method and Charlson comorbidity index (CCI) were independent prognostic factors for PFS (P=0.033 and P=0.001, respectively). Conclusion For patients with lung recurrence after radical NSCLC, no significant difference exists in the efficacy of SBRT and surgery.

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Comparison of the outcomes of sublobar resection and stereotactic body radiotherapy for stage T1-2N0M0 non-small cell lung cancer with tumor size ≤ 5 cm: a propensity score matching analysis

Cited by 6 publications

References 31 publications

The Role of Surgery in Lung Cancer Treatment: Present Indications and Future Perspectives—State of the Art

The Role of Surgery in Lung Cancer Treatment: Present Indications and Future Perspectives—State of the Art

Stereotactic body radiation therapy versus surgery for patients with early-stage non–small cell lung cancer( ≤ 5cm): A systematic review and meta-analysis

Treatment of lung recurrence after radical resection of non-small cell lung cancer: a single-center retrospective analysis using body stereotactic radiotherapy vs. reoperation

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