- Sublobar resection (SLR) for large stage I, node-negative (N0) NSCLC tumors was associated with 27% increase in all-cause mortality and 57% increase in cancer-specific mortality.
- However, study authors suggest SLR's high cancer-specific survival rate may make it an appropriate option for high-risk patients with carefully staged large N0 tumors.
Why this matters
- SLR is used in as many as 31% of surgical resection cases for clinically node-negative lung cancers, despite a lack of data from randomized clinical trials comparing oncological outcomes vs lobectomy.
- 4582 patients with stage I NSCLC N0 tumors >2 cm to 5 cm in size from the Surveillance, Epidemiology and End Results and Medicare-linked databases underwent SLR (n=692) or lobectomy (n=3890).
- 681 propensity-matched patient pairs.
- Funding: None disclosed.
- After matching, the SLR group was more likely to have no lymph node sampling (44.1% vs 7.5%; P<.001>
- After propensity-matching, the lobectomy group had better 5-year OS (47% vs 37%; P<.001 and cancer-specific survival vs p>
- SLR was associated with an increased risk of all-cause mortality (HR, 1.27; P=.001) and cancer-specific mortality death (HR, 1.57; P=.008).
- Retrospective design.