Treatment Outcomes in Stage I Lung Cancer: A Comparison of Surgery and Stereotactic Body Radiation Therapy

Retrospective study of surgery versus SBRT for clinical stage I NSCLC using the National Cancer Data Base (NCDB). Propensity score matching was used to create 5355 matched pairs. In that analysis, median survival for those undergoing surgery was 62.3 months versus 33.1 months in those undergoing SBRT. The 3-year survival was 68.5% in the surgery group and 46.0% in the SBRT group. An additional propensity score matching was used to create 4555 matched pairs of patients undergoing sublobar resection (wedge or segmentectomy) versus SBRT. In that analysis, median survival for those undergoing sublobar resection was 48.3 months versus 33.9 months in those undergoing SBRT. The 3-year survival was 61.7% in the surgery group and 47.0% in the SBRT group. The main finding of this study was that patients undergoing surgery for clinical stage I NSCLC have longer overall survival than those undergoing SBRT. The authors state that a limitation of the study is that despite propensity matching, there are unmeasured variables that contributed to treatment allocation.