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Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie

24.-26.10.2013, Basel, Schweiz

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Outcomes following sublobar resection, radiofrequency ablation and stereotactic body radiation therapy for stage I non-small cell lung cancer: a retrospective analysis

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  • S. Safi - Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Heidelberg
  • J. op den Winkel - Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Heidelberg
  • P. Huber - Department of Radiation Oncology, Heidelberg University Hospital and German Cancer Research Center, Heidelberg
  • C. P. Heussel - Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Heidelberg
  • T. Schneider - Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Heidelberg
  • H. Hoffmann - Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Heidelberg
  • H. Dienemann - Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Heidelberg

Deutsche Gesellschaft für Thoraxchirurgie. Österreichische Gesellschaft für Thoraxchirurgie. Schweizerische Gesellschaft für Thoraxchirurgie. Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie. Basel, Schweiz, 24.-26.10.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocS1.3

doi: 10.3205/13dgt010, urn:nbn:de:0183-13dgt0102

Published: October 14, 2013

© 2013 Safi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Lobectomy is standard treatment for stage I non-small cell lung cancer (NSCLC). However, after tumor board review sublobar resection (SLR), radiofrequency ablation (RFA) or stereotactic body radiation therapy (SBRT) may be offered to high-risk patients who are unfit for standard resection or who refuse surgical treatment. This study examines recurrence and survival rates in stage I NSCLC after SLR, RFA, or SBRT.

Methods: Patients with histologically proven clinical stage I NSCLC (cT1/2cN0) who were treated with SLR, RFA or SBRT were identified from a prospectively maintained institutional database and retrospectively analyzed. Clinical follow-up and CT scans were done at 3, 9, 15 and 21 months, and afterwards on an individual basis. Restaging was done when clinically symptomatic. Primary end points were overall survival and progression-free survival. Kaplan-Meier analysis and logrank test were used.

Results: Between January 2009 and December 2012 a total of 84 stage I NSCLC patients were treated with SLR (n=32, 20 men, 12 women; median age 68 years), RFA (n=19; 14 men, 5 women; median age 73 years) and SBRT (n=33; 22 men, 11 women; median age 74 years). Median follow-up for SLR, RFA and SBRT was 22.5, 19 and 14 months, respectively. 1-year progression-free survival was 84%, 73% and 54%, respectively. Median time to local recurrence for SLR, RFA and SBRT was 14.5 months, 8 months and 6 months, respectively. Probability of 1-year local control was 97% for SLR, 77% for RFA, and 56% for SBRT (p<0.05). Probability of 1- and 2-year overall survival was 93% and 84% for SLR versus 88% and 66% for RFA versus 95% and 65% for SBRT.

Conclusion: Although overall survival was not different between the 3 modalities, local control rates in surgical cases were higher as compared to RFA or SBRT.