HealthDay News — For stage I non-small-cell lung cancer, survival is better with lobectomy than stereotactic body radiation therapy (SBRT), although there is no difference for sublobar resection and SBRT, according to a study published in the Annals of Thoracic Surgery.

Alex K. Bryant, from the University of California San Diego in La Jolla, and colleagues compared cancer-specific survival among patients with biopsy-proven clinical stage I non-small-cell lung cancer receiving lobectomy, sublobar resection, or SBRT. Data were included for 4069 patients (449 SBRT, 2986 lobectomy, and 634 sublobar resection).

The researchers found that immediate post-procedural mortality was higher in the surgery groups than the SBRT group in unadjusted analysis. 

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After adjustment for confounders, including preoperative pulmonary function, smoking status, comorbidity, and staging work-up procedures, the analysis considering long-term survival found higher cancer-specific mortality for SBRT than lobectomy (subdistribution hazard ratio, 1.45; 95% CI, 1.09 to 1.94; P =.01), but no significant difference between SBRT and sublobar resection (subdistribution hazard ratio, 1.25; 95% CI, 0.93 to 1.68; P =.15).

“Among a large cohort of early-stage lung cancer patients, we found that lobectomy had improved survival compared with SBRT, although we found no survival difference between sublobar resection and SBRT,” the authors write.

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Bryant AK, Mundt RC, Sandhu AP. Stereotactic body radiation therapy vs surgery for early lung cancer among US veterans. Ann Thorac Surg. 2017 Nov 21. pii: S0003-4975(17)31099-8.