- Patients with stage IA-IB NSCLC who undergo lobectomy have significantly better long-term survival than those who receive stereotactic ablative radiotherapy (SABR).
Why this matters
- With the increasing use of SABR in early-stage NSCLC, data were needed on long-term outcomes compared with lobectomy, the current recommendation for stage I NSCLC in the new National Institute for Health and Care Excellence guidelines.
- 2373 patients with stage IA-IB NSCLC and performance status (PS) 0-2 underwent lobectomy (n=1897) or SABR (n=476).
- Funding: None.
- Independent predictors of SABR included stage IA disease, age ≥65 years, comorbidities, and PS 1-2.
- The median time between diagnosis and treatment was 17 days for the lobectomy group vs 73 days for SABR.
- There was no difference in all-cause mortality within 180 days of treatment or surgery.
- However, compared with lobectomy, all-cause mortality was significantly higher with SABR at:
- 1 year: aOR, 2.12 (95% CI, 1.35-3.31).
- 2 years: aOR, 2.20 (95% CI, 1.56-3.09).
- No data on lung function or tumor location or size.