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Lancet Oncol: Only radiotherapy and no surgery, the survival prognosis of stage IA NSCLC patients is completely without lobectomy + lymph node dissection!

 Last Update: 2021-09-29
 Source: Internet
 Author: User

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A previous collective analysis of STARS and ROSEL trials reported that the survival prognosis of early stage non-small cell lung cancer ( NSCLC ) treated with stereotactic ablation radiotherapy (SABR) is better than surgical treatment, but this analysis has obvious limitations
.

NSCLC

This study reports the long-term follow-up results of the revised STARS trial.
In this trial, the SABR group re-accumulated a larger sample size and adopted the propensity matching comparison specified by the prospective registration agreement.
It also included receiving video assistance.
A contemporary institutional cohort of thoracoscopic lobectomy and mediastinal lymph node dissection (VATS L-MLND)
.

video

The test patient is an N0M0 stage NSCLC patient (squamous cell carcinoma, adenocarcinoma, large cell carcinoma or NSCLC without specific classification) who is over 18 years old, Zubrod performance status 0-2 points, histologically confirmed, and newly diagnosed , and The tumor diameter is required to be ≤ 3 cm
.

The trial did not include patients in the previous pooled analysis

diagnosis

OS (A) and PFS (B) in patients treated with SABR or VATS L-MLND

From September 1, 2015 to January 31, 2017, a total of 80 patients were recruited, all of which were included in the efficacy and safety analysis
.

The median follow-up was 5.

The 3-year and 5-year overall survival rates of the VATS-MLND cohort were 91% (95% CI 85-98) and 84% (76-93) , respectively.

In summary, the long-term survival rate of surgically treatable stage IA NSCLC patients after stereotactic ablation radiotherapy is not inferior to thoracoscopic lobectomy + mediastinal lymph node dissection

IA NSCLC patients may be treated using surgical ablation of long-term survival after stereotactic radiotherapy is not inferior to the thoracic lobectomy + mediastinal lymph node dissection can IA surgical treatment of NSCLC patients with long-term survival after ablation stereotactic radiotherapy is not Inferior to thoracoscopic lobectomy + mediastinal lymph node dissection

Original source:

Joe Y Chang, et al.

Stereotactic ablative radiotherapy for operable stage I non -small-cell lung cancer (revised STARS): long-term results of a single-arm, prospective trial with prespecified comparison to surgery in this message

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