Mortality differed between surgery and radiotherapy; increased age had higher mortality after surgery
WEDNESDAY, Jan. 31, 2018 (HealthDay News) — For patients with early non-small-cell lung cancer, mortality rates are higher after surgery versus stereotactic body radiotherapy (SBRT), and the difference increases as a function of age, according to a study published online Jan. 18 in the Journal of Clinical Oncology.
William A. Stokes, M.D., from the University of Colorado School of Medicine in Aurora, and colleagues abstracted patients with cT1-T2a, N0, M0 non-small-cell lung cancer who were diagnosed between 2004 to 2013 and undergoing either surgery or SBRT. The authors identified 76,623 patients who underwent surgery, and 8,216 who underwent SBRT to calculate and compare 30- and 90-day post-treatment mortality rates between the two treatments.
The researchers found that mortality rates were moderately increased with surgery versus SBRT in the unmatched cohort (30 days: 2.07 versus 0.73 percent [absolute difference, 1.34 percent]; 90 days: 3.59 versus 2.93 percent [absolute difference, 0.66 percent]; P < 0.001 for both). These differences increased among the 27,200 propensity-score-matched patients (30 days: 2.41 versus 0.79 percent [absolute difference, 1.62 percent]; 90 days: 4.23 versus 2.82 percent [absolute difference, 1.41 percent]; P < 0.001 for both). With age, the differences in mortality between surgery and SBRT increased, with interaction P < 0.001 at both 30 and 90 days. Mortality rates were also higher for surgery versus SBRT with increased extent of resection.
“These representative mortality data may inform shared decision making among patients with early-stage non-small-cell lung cancer who are eligible for both interventions,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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