“Currently, most patients with stage IIIB non-small cell lung cancer are not candidates for surgery; instead, they are treated with chemotherapy and radiation only,” said Matthew J. Bott, MD, from Washington University in St. Louis, who led the study.
In stage IIIB NSCLC, the tumor usually has spread to lymph nodes or invaded other organs around the lungs, such as the heart, esophagus, or trachea. Patients with stage IIIB NSCLC have a 5-year overall survival rate of only 10%.
Dr. Bott and colleagues evaluated data from the National Cancer Database on 9,173 patients with stage IIIB NSCLC who had undergone combination treatment (multimodality therapy) between 1998 and 2010.
Patients were split into two groups: 7,459 patients who were treated with combined chemotherapy and radiation (CR group), and 1,714 patients who were treated with chemotherapy, radiation, and surgery (CRS group) in any order.
The researchers found that the median overall survival was more than 9 months longer in the CRS group than in the CR group (25.9 months vs. 16.3 months, respectively).
Because the patients in the CRS group tended to be younger, Caucasian, and have slightly smaller tumors than the patients in the CR group, Dr. Bott cautioned that surgery should be added to the treatment regimen only for carefully selected patients and that more research needs to be conducted before definitive guidelines can be established.
“We hope that our research reinvigorates discussion regarding the optimal treatment of these patients and leads to greater multidisciplinary evaluation of treatment options, with increased participation of thoracic surgeons in the decision-making process,” said Dr. Bott.
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Link to article on The Annals website: http://www.annalsthoracicsurgery.org/article/S0003-4975(15)00241-6/abstract
Founded in 1964, The Society of Thoracic Surgeons is a not-for-profit organization representing more than 7,000 cardiothoracic surgeons, researchers, and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society’s mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.
The Annals of Thoracic Surgery is the official journal of STS and the Southern Thoracic Surgical Association.
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