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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2015

01-01-2015 | Thoracic Oncology

Survival and Treatment of Non-small Cell Lung Cancer Stage I–II Treated Surgically or with Stereotactic Body Radiotherapy: Patient and Tumor-Specific Factors Affect the Prognosis

Authors: Sahar Mokhles, MD, Joost J. Nuyttens, MD, Alex P. W. M. Maat, MD, Özcan Birim, MD, Joachim G. J. V. Aerts, MD, Ad J. J. C. Bogers, MD, Johanna J. M. Takkenberg, MD

Published in: Annals of Surgical Oncology | Issue 1/2015

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Abstract

Background

This study was designed to define clinical baseline parameters associated with impaired survival of patients with stage I or II non-small cell lung cancer (NSCLC) who underwent surgery or stereotactic body radiotherapy (SBRT).

Methods

From January 2001 to January 2011, 425 patients (216 surgery, 209 SBRT) were identified with clinical stage I or II NSCLC. Cox proportional-hazards regression analyses were used to investigate risk factors for mortality.

Results

Median age of patients in the surgery and SBRT groups was 65 and 74 years, respectively. A smaller proportion of the surgical group had Charlson Comorbidity Index (CCI) score ≥1 compared with the SBRT group: 52 and 72 % (p < 0.001), respectively. Overall survival in the surgical group at 2 and 4 years was 79 and 65 %, respectively. In the SBRT group, this was 65 % at 2 years and 44 % at 4 years. In the surgical group older age, CCI score = 4 and clinical stage = IIB were associated with long-term mortality. In the SBRT group, this was CCI score ≥5 and clinical stage >IA. The area under the curve was calculated for the model with clinical and tumor factors: 0.77 for the surgery and 0.85 for the SBRT group.

Conclusions

Both patient characteristics and survival of NSCLC I–II patients undergoing surgical treatment or SBRT differ considerably. Long-term survival as a result of treatment strategy of NSCLC patients might be optimized by focusing on patient and tumor specific factors. In addition to TNM staging, the consideration of patient age and CCI can be useful for prognostication of NSCLC patients.
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Metadata
Title
Survival and Treatment of Non-small Cell Lung Cancer Stage I–II Treated Surgically or with Stereotactic Body Radiotherapy: Patient and Tumor-Specific Factors Affect the Prognosis
Authors
Sahar Mokhles, MD
Joost J. Nuyttens, MD
Alex P. W. M. Maat, MD
Özcan Birim, MD
Joachim G. J. V. Aerts, MD
Ad J. J. C. Bogers, MD
Johanna J. M. Takkenberg, MD
Publication date
01-01-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 1/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3860-x

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