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Sublobar Resection, Radiofrequency Ablation or Radiotherapy in Stage I Non-Small Cell Lung Cancer

Safi, Seyer ; Rauch, Geraldine ; op den Winkel, Jan ; Kunz, Josef ; Schneider, Thomas ; Bischof, Marc ; Heussel, Claus Peter ; Huber, Peter E. ; Herth, Felix J.F. ; Dienemann, Hendrik ; Hoffmann, Hans

In: Respiration, 89 (2015), Nr. 6. pp. 550-557. ISSN 0025-7931 (Print-Ausg.), 1423-0356 (Online-Ausg.)

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BACKGROUND: The best therapy for patients with stage I nonsmall cell lung cancer (NSCLC) who are medically unfit for lobectomy or prefer not to undergo surgery has not yet been demonstrated.

OBJECTIVES: We analyzed data from our prospective database to evaluate the recurrence and survival rates and assess the extent to which the type of treatment explains outcome differences.

METHODS: This study included 116 patients with histologically proven clinical stage I NSCLC who were treated with sublobar resection (SLR; n = 42), radiofrequency ablation (RFA; n = 25) or radiotherapy (RT; n = 49) between 2009 and 2013. The primary end point was the time to primary tumor recurrence (PR). Kaplan-Meier curves and Cox regression were used to compare the recurrence patterns and survivals after adjustments for potential confounders.

RESULTS: The SLR patients were younger and exhibited better performance status. The RT patients had larger tumors. After adjusting for age and tumor size, there were differences between the different treatments in terms of the PR rate, but no differences were observed in overall (OS) or disease-free survival. The hazard ratio for PR comparing SLR versus RT adjusted for age and tumor size was 2.73 (95% confidence interval, CI, 0.72–10.27) and that for SLR versus RFA was 7.57 (95% CI 1.94–29.47).

CONCLUSIONS: Our study suggests that SLR was associated with a higher primary tumor control rate compared to RFA or RT, although the OSs were not different. These results should be confirmed in prospective trials.

Document type: Article
Journal or Publication Title: Respiration
Volume: 89
Number: 6
Publisher: Karger
Place of Publication: Basel
Date Deposited: 21 Oct 2019 07:34
Date: 2015
ISSN: 0025-7931 (Print-Ausg.), 1423-0356 (Online-Ausg.)
Page Range: pp. 550-557
Faculties / Institutes: Service facilities > German Cancer Research Center (DKFZ)
Medizinische Fakultät Heidelberg > Institut für Medizinische Biometrie und Informatik
Medizinische Fakultät Heidelberg > Thoraxklinik Heidelberg gGmbH
DDC-classification: 610 Medical sciences Medicine
Uncontrolled Keywords: lung cancer surgery , radiation therapy , ablation
Additional Information: Dieser Beitrag ist aufgrund einer (DFG-geförderten) Allianz bzw. Nationallizenz frei zugänglich. This publication is freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
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