Scholarlink

Background <p>Surgical resection is the standard curative treatment for stage I non-small cell lung cancer (NSCLC), whereas stereotactic body radiotherapy (SBRT) is an established alternative for patients who are medically inoperable or decline surgery. However, comparative long-term oncologic outcomes remain debated. This study compared outcomes of surgery and SBRT in patients with clinical stage I NSCLC.</p> Methods <p>This retrospective two-center cohort study included 157 patients treated between 2010 and 2022 (93 surgery, 64 SBRT). The surgical cohort included a substantial proportion of thoracotomy procedures, reflecting routine clinical practice. Overall survival (OS), disease-free survival (DFS), local control (LC), and locoregional control (LRC) were estimated using Kaplan–Meier analysis. Multivariable Cox regression was used to adjust for baseline differences. Because histological confirmation was unavailable in a subset of SBRT patients, a sensitivity analysis restricted to histologically confirmed NSCLC cases (<i>n</i> = 143) was performed.</p> Results <p>Median follow-up was 57 months in the surgical group and 48 months in the SBRT group. Median OS, DFS, LC, and LRC numerically favored surgery, although no statistically significant differences were observed (<i>p</i> &gt; 0.05). Five-year OS was 58% after surgery and 49% after SBRT. The SBRT cohort had a higher burden of comorbidities (93% vs. 56%). Distant metastasis occurred more frequently after SBRT (28.1% vs. 15.1%, <i>p</i> = 0.006). Sensitivity analysis of histologically confirmed cases yielded results consistent with the primary analysis.</p> Conclusions <p>Surgical resection and SBRT demonstrated comparable oncologic outcomes in this real-world cohort of stage I NSCLC. SBRT remains an effective option for medically inoperable patients, whereas surgery offers the advantage of pathological staging in eligible individuals. Consistent findings in the histologically confirmed cohort support the robustness of these results. Prospective randomized trials are needed to further define optimal management.</p> Trial registration <p>Not applicable.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Comparison of prognosis between patients undergoing surgical resection and stereotactic ablative radiotherapy for early-stage lung cancer

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月14日

查看全文
  • Pelin Erdizci,
  • Elçin Ersöz Köse,
  • Mustafa Akyıl,
  • Cansel Atinkaya Baytemir,
  • Rashad Rzazade,
  • Selami Volkan Baysungur

摘要

Background

Surgical resection is the standard curative treatment for stage I non-small cell lung cancer (NSCLC), whereas stereotactic body radiotherapy (SBRT) is an established alternative for patients who are medically inoperable or decline surgery. However, comparative long-term oncologic outcomes remain debated. This study compared outcomes of surgery and SBRT in patients with clinical stage I NSCLC.

Methods

This retrospective two-center cohort study included 157 patients treated between 2010 and 2022 (93 surgery, 64 SBRT). The surgical cohort included a substantial proportion of thoracotomy procedures, reflecting routine clinical practice. Overall survival (OS), disease-free survival (DFS), local control (LC), and locoregional control (LRC) were estimated using Kaplan–Meier analysis. Multivariable Cox regression was used to adjust for baseline differences. Because histological confirmation was unavailable in a subset of SBRT patients, a sensitivity analysis restricted to histologically confirmed NSCLC cases (n = 143) was performed.

Results

Median follow-up was 57 months in the surgical group and 48 months in the SBRT group. Median OS, DFS, LC, and LRC numerically favored surgery, although no statistically significant differences were observed (p > 0.05). Five-year OS was 58% after surgery and 49% after SBRT. The SBRT cohort had a higher burden of comorbidities (93% vs. 56%). Distant metastasis occurred more frequently after SBRT (28.1% vs. 15.1%, p = 0.006). Sensitivity analysis of histologically confirmed cases yielded results consistent with the primary analysis.

Conclusions

Surgical resection and SBRT demonstrated comparable oncologic outcomes in this real-world cohort of stage I NSCLC. SBRT remains an effective option for medically inoperable patients, whereas surgery offers the advantage of pathological staging in eligible individuals. Consistent findings in the histologically confirmed cohort support the robustness of these results. Prospective randomized trials are needed to further define optimal management.

Trial registration

Not applicable.