Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer.
Identifieur interne : 000264 ( Main/Exploration ); précédent : 000263; suivant : 000265Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer.
Auteurs : Nicholas R. Mayne [États-Unis] ; Belle K. Lin [États-Unis] ; Alice J. Darling [États-Unis] ; Vignesh Raman [États-Unis] ; Deven C. Patel [États-Unis] ; Douglas Z. Liou [États-Unis] ; Thomas A. D'Amico [États-Unis] ; Chi-Fu Jeffrey Yang [États-Unis]Source :
- Annals of surgery [ 1528-1140 ] ; 2020.
Descripteurs français
- KwdFr :
- Carcinome pulmonaire non à petites cellules (anatomopathologie), Carcinome pulmonaire non à petites cellules (chirurgie), Carcinome pulmonaire non à petites cellules (mortalité), Carcinome pulmonaire non à petites cellules (radiothérapie), Délai jusqu'au traitement (MeSH), Facteurs temps (MeSH), Humains (MeSH), Radiochirurgie (MeSH), Stadification tumorale (MeSH), Taux de survie (MeSH), Tumeurs du poumon (anatomopathologie), Tumeurs du poumon (chirurgie), Tumeurs du poumon (mortalité), Tumeurs du poumon (radiothérapie), Études de cohortes (MeSH).
- MESH :
- anatomopathologie : Carcinome pulmonaire non à petites cellules, Tumeurs du poumon.
- chirurgie : Carcinome pulmonaire non à petites cellules, Tumeurs du poumon.
- mortalité : Carcinome pulmonaire non à petites cellules, Tumeurs du poumon.
- radiothérapie : Carcinome pulmonaire non à petites cellules, Tumeurs du poumon.
- Délai jusqu'au traitement, Facteurs temps, Humains, Radiochirurgie, Stadification tumorale, Taux de survie, Études de cohortes.
English descriptors
- KwdEn :
- COVID-19 (MeSH), Carcinoma, Non-Small-Cell Lung (mortality), Carcinoma, Non-Small-Cell Lung (pathology), Carcinoma, Non-Small-Cell Lung (radiotherapy), Carcinoma, Non-Small-Cell Lung (surgery), Cohort Studies (MeSH), Humans (MeSH), Lung Neoplasms (mortality), Lung Neoplasms (pathology), Lung Neoplasms (radiotherapy), Lung Neoplasms (surgery), Neoplasm Staging (MeSH), Radiosurgery (MeSH), SARS-CoV-2 (MeSH), Survival Rate (MeSH), Time Factors (MeSH), Time-to-Treatment (MeSH).
- MESH :
- mortality : Carcinoma, Non-Small-Cell Lung, Lung Neoplasms.
- pathology : Carcinoma, Non-Small-Cell Lung, Lung Neoplasms.
- radiotherapy : Carcinoma, Non-Small-Cell Lung, Lung Neoplasms.
- surgery : Carcinoma, Non-Small-Cell Lung, Lung Neoplasms.
- COVID-19, Cohort Studies, Humans, Neoplasm Staging, Radiosurgery, SARS-CoV-2, Survival Rate, Time Factors, Time-to-Treatment.
Abstract
OBJECTIVE
To evaluate the overall survival of patients with operable stage IA non-small-cell lung cancer (NSCLC) who undergo "early" SBRT (within 0-30 days after diagnosis) versus "delayed" surgery (90-120 days after diagnosis).
SUMMARY OF BACKGROUND DATA
During the COVID-19 pandemic, national guidelines have recommended patients with operable stage IA NSCLC to consider delaying surgery by at least 3 months or, alternatively, to undergo SBRT without delay. It is unknown which strategy is associated with better short- and long-term outcomes.
METHODS
Multivariable Cox proportional hazards modeling and propensity score-matched analysis was used to compare the overall survival of patients with stage IA NSCLC in the National Cancer Data Base from 2004 to 2015 who underwent "early" SBRT (0-30 days after diagnosis) versus that of patients who underwent "delayed" wedge resection (90-120 days after diagnosis).
RESULTS
During the study period, 570 (55%) patients underwent early SBRT and 475 (45%) underwent delayed wedge resection. In multivariable analysis, delayed resection was associated with improved survival [adjusted hazard ratio 0.61; (95% confidence interval (CI): 0.50-0.76)]. Propensity-score matching was used to create 2 groups of 279 patients each who received early SBRT or delayed resection that were well-matched with regard to baseline characteristics. The 5-year survival associated with delayed resection was 53% (95% CI: 45%-61%) which was better than the 5-year survival associated with early SBRT (31% [95% CI: 24%-37%]).
CONCLUSION
In this national analysis, for patients with stage IA NSCLC, extended delay of surgery was associated with improved survival when compared to early treatment with SBRT.
DOI: 10.1097/SLA.0000000000004363
PubMed: 33074904
PubMed Central: PMC7668323
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>COVID-19 (MeSH)</term>
<term>Carcinoma, Non-Small-Cell Lung (mortality)</term>
<term>Carcinoma, Non-Small-Cell Lung (pathology)</term>
<term>Carcinoma, Non-Small-Cell Lung (radiotherapy)</term>
<term>Carcinoma, Non-Small-Cell Lung (surgery)</term>
<term>Cohort Studies (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Lung Neoplasms (mortality)</term>
<term>Lung Neoplasms (pathology)</term>
<term>Lung Neoplasms (radiotherapy)</term>
<term>Lung Neoplasms (surgery)</term>
<term>Neoplasm Staging (MeSH)</term>
<term>Radiosurgery (MeSH)</term>
<term>SARS-CoV-2 (MeSH)</term>
<term>Survival Rate (MeSH)</term>
<term>Time Factors (MeSH)</term>
<term>Time-to-Treatment (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Carcinome pulmonaire non à petites cellules (anatomopathologie)</term>
<term>Carcinome pulmonaire non à petites cellules (chirurgie)</term>
<term>Carcinome pulmonaire non à petites cellules (mortalité)</term>
<term>Carcinome pulmonaire non à petites cellules (radiothérapie)</term>
<term>Délai jusqu'au traitement (MeSH)</term>
<term>Facteurs temps (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Radiochirurgie (MeSH)</term>
<term>Stadification tumorale (MeSH)</term>
<term>Taux de survie (MeSH)</term>
<term>Tumeurs du poumon (anatomopathologie)</term>
<term>Tumeurs du poumon (chirurgie)</term>
<term>Tumeurs du poumon (mortalité)</term>
<term>Tumeurs du poumon (radiothérapie)</term>
<term>Études de cohortes (MeSH)</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Carcinome pulmonaire non à petites cellules</term>
<term>Tumeurs du poumon</term>
</keywords>
<keywords scheme="MESH" qualifier="chirurgie" xml:lang="fr"><term>Carcinome pulmonaire non à petites cellules</term>
<term>Tumeurs du poumon</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Carcinoma, Non-Small-Cell Lung</term>
<term>Lung Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Carcinome pulmonaire non à petites cellules</term>
<term>Tumeurs du poumon</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Carcinoma, Non-Small-Cell Lung</term>
<term>Lung Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Carcinoma, Non-Small-Cell Lung</term>
<term>Lung Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Carcinome pulmonaire non à petites cellules</term>
<term>Tumeurs du poumon</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Carcinoma, Non-Small-Cell Lung</term>
<term>Lung Neoplasms</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>COVID-19</term>
<term>Cohort Studies</term>
<term>Humans</term>
<term>Neoplasm Staging</term>
<term>Radiosurgery</term>
<term>SARS-CoV-2</term>
<term>Survival Rate</term>
<term>Time Factors</term>
<term>Time-to-Treatment</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Délai jusqu'au traitement</term>
<term>Facteurs temps</term>
<term>Humains</term>
<term>Radiochirurgie</term>
<term>Stadification tumorale</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>To evaluate the overall survival of patients with operable stage IA non-small-cell lung cancer (NSCLC) who undergo "early" SBRT (within 0-30 days after diagnosis) versus "delayed" surgery (90-120 days after diagnosis).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>SUMMARY OF BACKGROUND DATA</b>
</p>
<p>During the COVID-19 pandemic, national guidelines have recommended patients with operable stage IA NSCLC to consider delaying surgery by at least 3 months or, alternatively, to undergo SBRT without delay. It is unknown which strategy is associated with better short- and long-term outcomes.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>Multivariable Cox proportional hazards modeling and propensity score-matched analysis was used to compare the overall survival of patients with stage IA NSCLC in the National Cancer Data Base from 2004 to 2015 who underwent "early" SBRT (0-30 days after diagnosis) versus that of patients who underwent "delayed" wedge resection (90-120 days after diagnosis).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>During the study period, 570 (55%) patients underwent early SBRT and 475 (45%) underwent delayed wedge resection. In multivariable analysis, delayed resection was associated with improved survival [adjusted hazard ratio 0.61; (95% confidence interval (CI): 0.50-0.76)]. Propensity-score matching was used to create 2 groups of 279 patients each who received early SBRT or delayed resection that were well-matched with regard to baseline characteristics. The 5-year survival associated with delayed resection was 53% (95% CI: 45%-61%) which was better than the 5-year survival associated with early SBRT (31% [95% CI: 24%-37%]).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>In this national analysis, for patients with stage IA NSCLC, extended delay of surgery was associated with improved survival when compared to early treatment with SBRT.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33074904</PMID>
<DateCompleted><Year>2020</Year>
<Month>12</Month>
<Day>04</Day>
</DateCompleted>
<DateRevised><Year>2021</Year>
<Month>01</Month>
<Day>25</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1528-1140</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>272</Volume>
<Issue>6</Issue>
<PubDate><Year>2020</Year>
<Month>12</Month>
</PubDate>
</JournalIssue>
<Title>Annals of surgery</Title>
<ISOAbbreviation>Ann Surg</ISOAbbreviation>
</Journal>
<ArticleTitle>Stereotactic Body Radiotherapy Versus Delayed Surgery for Early-stage Non-small-cell Lung Cancer.</ArticleTitle>
<Pagination><MedlinePgn>925-929</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1097/SLA.0000000000004363</ELocationID>
<Abstract><AbstractText Label="OBJECTIVE">To evaluate the overall survival of patients with operable stage IA non-small-cell lung cancer (NSCLC) who undergo "early" SBRT (within 0-30 days after diagnosis) versus "delayed" surgery (90-120 days after diagnosis).</AbstractText>
<AbstractText Label="SUMMARY OF BACKGROUND DATA">During the COVID-19 pandemic, national guidelines have recommended patients with operable stage IA NSCLC to consider delaying surgery by at least 3 months or, alternatively, to undergo SBRT without delay. It is unknown which strategy is associated with better short- and long-term outcomes.</AbstractText>
<AbstractText Label="METHODS">Multivariable Cox proportional hazards modeling and propensity score-matched analysis was used to compare the overall survival of patients with stage IA NSCLC in the National Cancer Data Base from 2004 to 2015 who underwent "early" SBRT (0-30 days after diagnosis) versus that of patients who underwent "delayed" wedge resection (90-120 days after diagnosis).</AbstractText>
<AbstractText Label="RESULTS">During the study period, 570 (55%) patients underwent early SBRT and 475 (45%) underwent delayed wedge resection. In multivariable analysis, delayed resection was associated with improved survival [adjusted hazard ratio 0.61; (95% confidence interval (CI): 0.50-0.76)]. Propensity-score matching was used to create 2 groups of 279 patients each who received early SBRT or delayed resection that were well-matched with regard to baseline characteristics. The 5-year survival associated with delayed resection was 53% (95% CI: 45%-61%) which was better than the 5-year survival associated with early SBRT (31% [95% CI: 24%-37%]).</AbstractText>
<AbstractText Label="CONCLUSION">In this national analysis, for patients with stage IA NSCLC, extended delay of surgery was associated with improved survival when compared to early treatment with SBRT.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mayne</LastName>
<ForeName>Nicholas R</ForeName>
<Initials>NR</Initials>
<AffiliationInfo><Affiliation>Department of Surgery, Duke University, Durham, North Carolina.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lin</LastName>
<ForeName>Belle K</ForeName>
<Initials>BK</Initials>
<AffiliationInfo><Affiliation>University of Arizona College of Medicine-Phoenix, Phoenix, Arizona.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Darling</LastName>
<ForeName>Alice J</ForeName>
<Initials>AJ</Initials>
<AffiliationInfo><Affiliation>Department of Surgery, Duke University, Durham, North Carolina.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Raman</LastName>
<ForeName>Vignesh</ForeName>
<Initials>V</Initials>
<AffiliationInfo><Affiliation>Department of Surgery, Duke University, Durham, North Carolina.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Patel</LastName>
<ForeName>Deven C</ForeName>
<Initials>DC</Initials>
<AffiliationInfo><Affiliation>Department of Cardiothoracic Surgery, Stanford University, Stanford, California.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Liou</LastName>
<ForeName>Douglas Z</ForeName>
<Initials>DZ</Initials>
<AffiliationInfo><Affiliation>Department of Cardiothoracic Surgery, Stanford University, Stanford, California.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Stanford Health Care ValleyCare, Pleasanton, California.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>D'Amico</LastName>
<ForeName>Thomas A</ForeName>
<Initials>TA</Initials>
<AffiliationInfo><Affiliation>Department of Surgery, Duke University, Durham, North Carolina.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Yang</LastName>
<ForeName>Chi-Fu Jeffrey</ForeName>
<Initials>CJ</Initials>
<AffiliationInfo><Affiliation>Department of Surgery, Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType>
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<MedlineTA>Ann Surg</MedlineTA>
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<ISSNLinking>0003-4932</ISSNLinking>
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