Matched-pair comparison of outcome of patients with clinical stage I non-small cell lung cancer treated with resection or stereotactic radiosurgery.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7040-7040
Author(s):  
Julia Shelkey ◽  
Achilles Fakiris ◽  
Malcolm M. DeCamp ◽  
Laura Nyshel Medford-Davis ◽  
John Charles Flickinger ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Clinical Stage ◽  
Small Cell ◽  
Matched Pair ◽  
Small Cell Lung ◽  
Matched Pair Analysis ◽  
Pair Analysis

7040 Background: Stereotactic body radiotherapy (SBRT) is an alternative to surgery alone for certain patients with clinical stage I non-small cell lung cancer (NSCLC), but comparing their effectiveness is difficult because of differences in patient selection and staging. Methods: Two databases were combined which contained 132 patients treated by lobectomy (LR) and 48 by sublobar resection (SLR) and 137 patients managed with SBRT after negative staging between 1999-2009. We compared rates of overall survival (OS), disease-free survival (DFS), and locoregional control (LRC) between patients treated with surgery and SBRT to each other and in relation to possible prognostic factors. We then performed a matched-pair analysis comparing surgery and SBRT results. Median follow-up for the entire study population was 25.8 months. Results: On univariate analysis, OS was significantly correlated with histology, the Charlson Comorbidity Index, tumor size, aspirin use, and use of SBRT; DFS was correlated only with histology; and no variable was significantly correlated with LRC. Multivariate analysis found improved OS in patients with adenocarcinoma and those undergoing surgical resection. The NSCLC “not otherwise specified” histology was associated with poorer DFS. Overall survival was significantly poorer for SBRT patients in the matched-pair analysis than for patients treated with surgery, but DFS and LRC were not significantly different between these groups. Conclusions: Our retrospective study has demonstrated similar LRC and DFS in patients treated with SBRT or surgery, but worse OS in the former group, when patients were matched for prognostic factors. Our investigation suggests that randomized trials are needed to eliminate selection bias in treatment assignment in order to accurately compare outcomes between these approaches.

Matched-Pair Analysis of High Dose Versus Standard Dose Definitive Chemoradiation for Locally Advanced Non–Small-Cell Lung Cancer

2017 ◽  
Vol 18 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Matthew D. Johnson ◽  
Karna Sura ◽  
Victor S. Mangona ◽  
Alexander Glick ◽  
Michelle Wallace ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Standard Dose ◽  
Locally Advanced ◽  
Small Cell ◽  
Matched Pair ◽  
High Dose ◽  
Small Cell Lung ◽  
Matched Pair Analysis ◽  
Pair Analysis

scholarly journals Determination of prognostic factors of surgically treated pathological Stage IIIA non-small cell lung cancer

2020 ◽  
Vol 28 (3) ◽  
pp. 496-504
Author(s):  
Muhammet Sayan
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Disease Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Free Survival ◽  
Disease Free

Background: This study aims to identify the prognostic factors in Stage IIIA non-small cell lung cancer and to investigate whether there was a significant difference in terms of overall survival and disease-free survival among the subgroups belonging to this disease stage. Methods: Between January 2010 and December 2018, a total of 144 patients (125 males, 19 females; median age 60 years; range, 41 to 80 years) who were operated for non-small cell lung cancer in our clinic and whose pathological stage was reported as IIIA were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, histopathological diagnosis, the standardized uptake value of the mass on positron emission tomography-computed tomography, tumor diameter, type of surgery, lymph node metastasis status, visceral pleural invasion, and overall and disease-free survival rates were recorded. Results: The median survival was 39 (range, 27.8 to 46.1) months and the five-year overall survival rate was 28%. The mean tumor diameter was 4.3±2.7 cm. The median disease-free survival was 37 (range, 28.1 to 48.6) months and the five-year disease-free survival rate was 26.9%. In the multivariate analysis, overall survival and disease-free survival in T2N2M0 subgroup were significantly worse than the other subgroups. The other poor prognostic factors of survival were the standardized uptake value of the tumor, pneumonectomy, and histopathological subtypes other than squamous cell carcinoma and adenocarcinoma. Parietal pleural invasion was significantly associated with worse disease-free survival rates. Conclusion: Our results showed that there may be significant survival differences between subgroups created by tumor histopathology, lymph node invasion and the type of surgery in a heterogeneous lung cancer stage.

scholarly journals P2.03b-097 Prognostic Factors for Overall Survival among Patients with Advanced/Metastatic Non-Small Cell Lung Cancer (NSCLC)

2017 ◽  
Vol 12 (1) ◽  
pp. S995-S996
Author(s):  
Katharina Verleger ◽  
Maarten Treur ◽  
John Penrod ◽  
Melinda Daumont ◽  
Michael Lees ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung

Trends in pneumonectomy for treatment of small-cell lung cancer

2020 ◽  
Vol 28 (9) ◽  
pp. 583-591
Author(s):  
Jasmine Zhao ◽  
Alexandra Nguyen ◽  
Li Ding ◽  
Elizabeth A David ◽  
Scott M Atay ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Clinical Stage ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Lung Cancer Patients

Background According to practice guidelines, patients with clinical stage T1–2 node-negative small-cell lung cancer are candidates for surgical resection. However, the role of pneumonectomy in small-cell lung cancer patients is not well understood. The objective of this study was to assess the extent to which pneumonectomy is used and to evaluate the survival implications for small-cell lung cancer patients who underwent pneumonectomy. Methods A total of 106 small-cell lung cancer patients who underwent pneumonectomy between 2006 and 2016 and met the study criteria were identified in the National Cancer Database. Demographics and treatment regimens are described, and overall survival was assessed using Kaplan-Meier and log-rank tests. Results The most common treatment was surgery with adjuvant chemotherapy, followed by surgery only and surgery with neoadjuvant therapy. The 5-year overall survival for the entire cohort after pneumonectomy was 23%. In subgroup analysis, the 5-year overall survival was 30% for guideline-concordant clinical stage I patients and 28% for clinical stage II/III patients who underwent pneumonectomy. There was no statistical difference in survival according to pathologic N disease. Patients with a right-sided pneumonectomy had higher mortality than patients with a left-sided pneumonectomy. Conclusions This study suggests a role for pneumonectomy in clinical stage I and potentially some clinical stage II and III small-cell lung cancer patients. Right-sided pneumonectomy is associated with higher mortality and should be approached with caution. Despite declining trends over the past decades, pneumonectomy is still an effective treatment that is able to achieve acceptable survival outcomes.

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