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Objectives <p>We compared the overall survival (OS) and cancer-specific survival (CSS) of patients who received radiotherapy and surgery, respectively, in a large population.</p> Methods <p>In this study, we counted the patients diagnosed with stage IA lung adenocarcinoma in the SEER database from 2015 to 2019. We compared the overall survival (OS) and cancer-specific survival (CSS) through Kaplan Meier analysis, balanced the differences of primary data through propensity score matching (PSM), screened independent prognostic factors through Cox regression analysis, and then compared the survival differences of different treatment methods through hierarchical analysis.</p> Results <p>Among 11,159 patients with stage IA lung adenocarcinoma, 4254 patients chose radiotherapy alone (38.1%), and 6688 patients were finally included through the propensity score matching. The median survival time for patients with radiotherapy alone was 53&#xa0;months, while the patients with surgery alone did not reach the median survival time (<i>p</i> &lt; 0.001). Multivariate analysis showed that age, sex, tumor size, and household income affected the prognosis of patients. The results of the stratified analysis showed that, except in the subgroup of age ≤ 50&#xa0;years, almost all subgroup analyses showed that surgical treatment achieved better results.</p> Conclusions <p>Radiotherapy alone can be used as an option for patients with stage IA lung adenocarcinoma who cannot tolerate surgery, but the benefit to patients is limited, and surgical treatment may still be the best choice.</p>

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Survival benefit of surgery vs radiotherapy alone to patients with stage IA lung adenocarcinoma: a propensity score-matched analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月15日

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  • Dejun Zeng,
  • Zhencong Chen,
  • Ming Li,
  • Yanjun Yi,
  • Zhengyang Hu,
  • Besskaya Valeria,
  • Guangyao Shan,
  • Cheng Zhan,
  • Junjie Xi,
  • Qun Wang,
  • Zongwu Lin

摘要

Objectives

We compared the overall survival (OS) and cancer-specific survival (CSS) of patients who received radiotherapy and surgery, respectively, in a large population.

Methods

In this study, we counted the patients diagnosed with stage IA lung adenocarcinoma in the SEER database from 2015 to 2019. We compared the overall survival (OS) and cancer-specific survival (CSS) through Kaplan Meier analysis, balanced the differences of primary data through propensity score matching (PSM), screened independent prognostic factors through Cox regression analysis, and then compared the survival differences of different treatment methods through hierarchical analysis.

Results

Among 11,159 patients with stage IA lung adenocarcinoma, 4254 patients chose radiotherapy alone (38.1%), and 6688 patients were finally included through the propensity score matching. The median survival time for patients with radiotherapy alone was 53 months, while the patients with surgery alone did not reach the median survival time (p < 0.001). Multivariate analysis showed that age, sex, tumor size, and household income affected the prognosis of patients. The results of the stratified analysis showed that, except in the subgroup of age ≤ 50 years, almost all subgroup analyses showed that surgical treatment achieved better results.

Conclusions

Radiotherapy alone can be used as an option for patients with stage IA lung adenocarcinoma who cannot tolerate surgery, but the benefit to patients is limited, and surgical treatment may still be the best choice.