Lobectomy bests SABR in stage I NSCLC

  • Khakwani A & al.
  • Thorax
  • 26 Dec 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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.

Study design

  • 2373 patients with stage IA-IB NSCLC and performance status (PS) 0-2 underwent lobectomy (n=1897) or SABR (n=476).
  • Funding: None.

Key results

  • 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).

Limitations

  • No data on lung function or tumor location or size.