Scholars@Duke publication: Tumor Size, Histology, and Survival After Stereotactic Ablative Radiotherapy and Sublobar Resection in Node-negative Non-small Cell Lung Cancer.

Tumor Size, Histology, and Survival After Stereotactic Ablative Radiotherapy and Sublobar Resection in Node-negative Non-small Cell Lung Cancer.

Publication , Journal Article

Raman, V; Jawitz, OK; Cerullo, M; Voigt, SL; Rhodin, KE; Yang, C-FJ; D'Amico, TA; Harpole, DH; Kelsey, CR; Tong, BC

Published in: Ann Surg

December 1, 2022

BACKGROUND: Although SABR is increasingly emerging as an alternative to surgery for node-negative non-small cell lung cancer, there is poor understanding of patients who may most benefit SABR compared to surgery. OBJECTIVE: This study examined the relationship between tumor size and the comparative outcomes of SABR and sublobar resection in patients with node-negative non-small cell lung cancer. RESULTS: A total of 59,949 patients met study criteria: 19,888 (33%) underwent SABR, 33,052 (55%) wedge resection, and 7009 (12%) segmental resection. In multivariable regression, a significant 3-way interaction was found between histology, tumor size, and type of treatment. After stratification by histology, a significant interaction between tumor size and treatment was preserved for patients with adenocarcinoma and squamous cell carcinoma. Sublobar resection was associated with greater survival compared to SABR for tumor sizes greater than 6 and 8 mm for patients with adenocarcinoma and squamous cell carcinoma, respectively. SABR was associated with similar survival compared to sublobar resection for patients with papillary and large cell histology. CONCLUSIONS: In this National Cancer Database analysis, sublobar resection was associated with greater survival compared to SABR for lesions >6or 8 mm in patients with adenocarcinoma or squamous cell carcinoma; however, SABR was associated with similar survival compared to sublobar resection in patients with aggressive tumors including papillary and large cell histology. Histologic diagnosis in patients with even small tumors may enable better treatment selection in those who cannot tolerate lobectomy.

Duke Scholars

Author David Harold Harpole Jr. Surgery, Cardiovascular and Thoracic Surgery

Author Marcelo Cerullo

Author Oliver Jawitz

Author Kristen Rhodin

Author Thomas Anthony D'Amico Surgery, Cardiovascular and Thoracic Surgery

Author Christopher Ryan Kelsey Radiation Oncology

Author Betty Caroline Tong Surgery, Cardiovascular and Thoracic Surgery

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Published In

Ann Surg

DOI

10.1097/SLA.0000000000004730

EISSN

1528-1140

Publication Date

December 1, 2022

Volume

276

Issue

Start / End Page

e1000 / e1007

Location

United States

Related Subject Headings

Treatment Outcome
Surgery
Pneumonectomy
Neoplasm Staging
Lung Neoplasms
Humans
Carcinoma, Squamous Cell
Carcinoma, Non-Small-Cell Lung
Adenocarcinoma
3202 Clinical sciences

Citation

APA

Chicago

ICMJE

MLA

NLM

Raman, V., Jawitz, O. K., Cerullo, M., Voigt, S. L., Rhodin, K. E., Yang, C.-F., … Tong, B. C. (2022). Tumor Size, Histology, and Survival After Stereotactic Ablative Radiotherapy and Sublobar Resection in Node-negative Non-small Cell Lung Cancer. Ann Surg, 276(6), e1000–e1007. https://doi.org/10.1097/SLA.0000000000004730

Raman, Vignesh, Oliver K. Jawitz, Marcelo Cerullo, Soraya L. Voigt, Kristen E. Rhodin, Chi-Fu Jeffrey Yang, Thomas A. D’Amico, David H. Harpole, Christopher R. Kelsey, and Betty C. Tong. “Tumor Size, Histology, and Survival After Stereotactic Ablative Radiotherapy and Sublobar Resection in Node-negative Non-small Cell Lung Cancer.” Ann Surg 276, no. 6 (December 1, 2022): e1000–1007. https://doi.org/10.1097/SLA.0000000000004730.

Raman V, Jawitz OK, Cerullo M, Voigt SL, Rhodin KE, Yang C-FJ, et al. Tumor Size, Histology, and Survival After Stereotactic Ablative Radiotherapy and Sublobar Resection in Node-negative Non-small Cell Lung Cancer. Ann Surg. 2022 Dec 1;276(6):e1000–7.

Raman, Vignesh, et al. “Tumor Size, Histology, and Survival After Stereotactic Ablative Radiotherapy and Sublobar Resection in Node-negative Non-small Cell Lung Cancer.” Ann Surg, vol. 276, no. 6, Dec. 2022, pp. e1000–07. Pubmed, doi:10.1097/SLA.0000000000004730.

Raman V, Jawitz OK, Cerullo M, Voigt SL, Rhodin KE, Yang C-FJ, D’Amico TA, Harpole DH, Kelsey CR, Tong BC. Tumor Size, Histology, and Survival After Stereotactic Ablative Radiotherapy and Sublobar Resection in Node-negative Non-small Cell Lung Cancer. Ann Surg. 2022 Dec 1;276(6):e1000–e1007.