Early-Stage Non-Small Cell Lung Cancer Mortality With Surgery vs Radiotherapy

HealthDay News — For patients with early non-small cell lung cancer (NSCLC), mortality rates are higher after surgery vs stereotactic body radiotherapy (SBRT), and the difference increases as a function of age, according to a study published in the Journal of Clinical Oncology.

William A. Stokes, MD, from the University of Colorado School of Medicine in Aurora, and colleagues abstracted patients with cT1-T2a, N0, M0 non-small cell lung cancer who were diagnosed between 2004 to 2013 and undergoing either surgery or SBRT. The authors identified 76,623 patients who underwent surgery, and 8216 who underwent SBRT to calculate and compare 30- and 90-day post-treatment mortality rates between the two treatments.

The researchers found that mortality rates were moderately increased with surgery vs SBRT in the unmatched cohort (30 days: 2.07% vs 0.73% [absolute difference, 1.34%]; 90 days: 3.59% vs 2.93% [absolute difference, 0.66%]; P < .001 for both). These differences increased among the 27,200 propensity-score-matched patients (30 days: 2.41% vs 0.79% [absolute difference, 1.62%]; 90 days: 4.23% vs 2.82% [absolute difference, 1.41%]; P < .001 for both). With age, the differences in mortality between surgery and SBRT increased, with interaction P < .001 at both 30 and 90 days. Mortality rates were also higher for surgery vs SBRT with increased extent of resection.

“These representative mortality data may inform shared decision making among patients with early-stage non-small cell lung cancer who are eligible for both interventions,” the authors wrote.

Disclosures: Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Stokes WA, Bronsert MR, Mequid RA, et al. Post-treatment mortality after surgery and stereotactic body radiotherapy for early-stage non-small-cell lung cancer [published January 18, 2018]. J Clin Oncol. doi:10.1200/JCO.2017.75.6536.