Original articleGeneral thoracicVideo-Assisted Thoracoscopic Lobectomy Versus Stereotactic Radiotherapy for Stage I Lung Cancer
Section snippets
Patients and Methods
This study was approved by the Institutional Review Board of Kyoto University Hospital (reference number: E1993). The requirement for patient consent was waived. Retrospective chart review was performed on the prospectively maintained databases in the Department of Thoracic Surgery and Department of Radiation Oncology and Image-Applied Therapy at Kyoto University Hospital.
Included in this study were 413 Asian patients who underwent VATS lobectomy for a biopsy-proven, solitary, clinical stage I
Comparisons Before Propensity Score Matching
Hazard ratio (95% confidence interval) of VATS lobectomy to SBRT and p value for each endpoint were as follows, on the basis of a Cox proportional hazard model, adjusted for age, gender, tumor diameter, CCI, and % FEV1: OS, 0.58 (0.33 to 0.997) and p = 0.049; CSS, 0.483 (0.242 to 0.964) and p < 0.0001; RFS, 0.483 (0.294 to 0.80) and p = 0.00042; local control, 0.137 (0.045 to 0.41) and p = 0.0004; regional LN control, 0.489 (0.152 to 1.57) and p = 0.229; and distant control, 0.445 (0.228
Comment
Stereotactic body radiotherapy may be a reasonable alternative to surgical treatment for early-stage NSCLC in medically compromised or inoperable patients [1]. The role of SBRT in potentially operable patients has remained to be determined. Surgery has been recommended for operable patients with early-stage NSCLC because surgery is more diagnostic and enables nodal staging and adjuvant treatments for node-positive patients [1]. However, comparative studies on surgery versus SBRT in potentially
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Masatsugu Hamaji and Fengshi Chen contributed equally to this work.