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Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer.

Publication ,  Journal Article
Mayne, NR; Lin, BK; Darling, AJ; Raman, V; Patel, DC; Liou, DZ; D'Amico, TA; Yang, C-FJ
Published in: Ann Surg
December 2020

OBJECTIVE: To evaluate the overall survival of patients with operable stage IA non-small-cell lung cancer (NSCLC) who undergo "early" SBRT (within 0-30 days after diagnosis) versus "delayed" surgery (90-120 days after diagnosis). SUMMARY OF BACKGROUND DATA: During the COVID-19 pandemic, national guidelines have recommended patients with operable stage IA NSCLC to consider delaying surgery by at least 3 months or, alternatively, to undergo SBRT without delay. It is unknown which strategy is associated with better short- and long-term outcomes. METHODS: Multivariable Cox proportional hazards modeling and propensity score-matched analysis was used to compare the overall survival of patients with stage IA NSCLC in the National Cancer Data Base from 2004 to 2015 who underwent "early" SBRT (0-30 days after diagnosis) versus that of patients who underwent "delayed" wedge resection (90-120 days after diagnosis). RESULTS: During the study period, 570 (55%) patients underwent early SBRT and 475 (45%) underwent delayed wedge resection. In multivariable analysis, delayed resection was associated with improved survival [adjusted hazard ratio 0.61; (95% confidence interval (CI): 0.50-0.76)]. Propensity-score matching was used to create 2 groups of 279 patients each who received early SBRT or delayed resection that were well-matched with regard to baseline characteristics. The 5-year survival associated with delayed resection was 53% (95% CI: 45%-61%) which was better than the 5-year survival associated with early SBRT (31% [95% CI: 24%-37%]). CONCLUSION: In this national analysis, for patients with stage IA NSCLC, extended delay of surgery was associated with improved survival when compared to early treatment with SBRT.

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Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

December 2020

Volume

272

Issue

6

Start / End Page

925 / 929

Location

United States

Related Subject Headings

  • Time-to-Treatment
  • Time Factors
  • Survival Rate
  • Surgery
  • SARS-CoV-2
  • Radiosurgery
  • Neoplasm Staging
  • Lung Neoplasms
  • Humans
  • Cohort Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mayne, N. R., Lin, B. K., Darling, A. J., Raman, V., Patel, D. C., Liou, D. Z., … Yang, C.-F. (2020). Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer. Ann Surg, 272(6), 925–929. https://doi.org/10.1097/SLA.0000000000004363
Mayne, Nicholas R., Belle K. Lin, Alice J. Darling, Vignesh Raman, Deven C. Patel, Douglas Z. Liou, Thomas A. D’Amico, and Chi-Fu Jeffrey Yang. “Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer.Ann Surg 272, no. 6 (December 2020): 925–29. https://doi.org/10.1097/SLA.0000000000004363.
Mayne NR, Lin BK, Darling AJ, Raman V, Patel DC, Liou DZ, et al. Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer. Ann Surg. 2020 Dec;272(6):925–9.
Mayne, Nicholas R., et al. “Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer.Ann Surg, vol. 272, no. 6, Dec. 2020, pp. 925–29. Pubmed, doi:10.1097/SLA.0000000000004363.
Mayne NR, Lin BK, Darling AJ, Raman V, Patel DC, Liou DZ, D’Amico TA, Yang C-FJ. Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer. Ann Surg. 2020 Dec;272(6):925–929.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

December 2020

Volume

272

Issue

6

Start / End Page

925 / 929

Location

United States

Related Subject Headings

  • Time-to-Treatment
  • Time Factors
  • Survival Rate
  • Surgery
  • SARS-CoV-2
  • Radiosurgery
  • Neoplasm Staging
  • Lung Neoplasms
  • Humans
  • Cohort Studies