The authors queried the National Cancer Data Base to assess outcomes of patients with R1 resection margins related to the presence and type of postoperative adjuvant therapy. 3.1% of over 54,000 resections had R1 margins, which negatively affected long-term survival. Combined chemotherapy and radiation therapy improved outcomes; administration of c
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Lung Cancer - Surgery
Impact of Adjuvant Treatment for Microscopic Residual Disease After Non-Small Cell Lung Cancer Surgery
February 2, 2015
VATS Lobectomy Has Better Perioperative Outcomes Than Open Lobectomy: CALGB 31001, an Ancillary Analysis of CALGB 140202 (Alliance)
February 2, 2015
This study propensity-score matched patients from a cohort who underwent resection for stage I or II lung cancer and compared 175 pairs who underwent VATS or open lobectomy. The VATS group experienced shorter hospital length of stay, fewer complications, and more frequent discharge to home. Survival was similar.
Prognostic Nomogram to Predict Survival After Surgery for Synchronous Multiple Lung Cancers in Multiple Lobes
January 29, 2015
This meta-analysis of 6 prior publications analyzed factors associated with outcomes after resection of synchronous lung cancers. Favorable predictors of survival were exclusive adenocarcinoma, small T size, bilateral disease, no nodal involvement, young age, and female sex.
January 29, 2015
There is growing recognition that hospital mortality is not an accurate metric for surgery-related mortality after cancer operations. This article evaluated SEER data for 1-month mortality after cancer surgery in nearly 54,000 patients. 4.8% died within 1 month of surgery. Favorable factors included being married, being insured, having an above-me
December 3, 2014
This study explored recent patterns of surveillance imaging 4-8 mos after surgical treatment of early stage lung cancer using the SEER database. Initial imaging consisted of CXR (60%), CT (25%) and PET (3%). 13% of patients received no imaging. NCCN guidelines adherence for receipt of CT was 47%, but increased from 28% to 60% over the period of st
November 20, 2014
Data from 20 observational studies including nearly 3000 pts were reviewed to assess the prevalence of pre-frailty/frailty and clinical outcomes in older cancer patients. Frailty was identified in 42% and pre-frailty in 43% of patients. Combined frailty was associated with increased all cause mortality (5-yr HR 1.57), postoperative mortality, and p
Quantifying the Safety Benefits of Wedge Resection: A Society of Thoracic Surgery Database Propensity-Matched Analysis
November 5, 2014
The potential benefit of wedge resection vs anatomic resection for stage I and II lung cancer was examined using propensity score matching for pts from the STS Database. Over 3700 pts were matched in each group. Wedge resection was associated with fewer major complications (4.5% vs 9.0%) and lower mortality (1.2% vs 1.9%). Wedge resection reduced
A Propensity-Matched Analysis of Wedge Resection and Stereotactic Body Radiotherapy for Early Stage Lung Cancer
October 1, 2014
Using a single institution database, the authors propensity score matched patients receiving wedge resection, wedge resection plus brachytherapy, or SBRT for early stage NSCLC. Survival was assessed at a median of 35 mos. Overall recurrence was higher for SBRT vs wedge (30% vs 9%), and recurrence-free and disease-free survival were better after wed
Impact of Brachytherapy on Local Recurrence Rates After Sublobar Resection: Results From ACOSOG Z4032 (Alliance), a Phase III Randomized Trial for High-Risk Operable Non–Small-Cell Lung Cancer
August 9, 2014
This multiinstitutional randomized trial compared sublobar resection alone to sublobar resection with adjuvant brachytherapy in high risk patients with peripheral NSCLC <3cm. Time to and type of local recurrence were similar between the groups. Brachytherapy did not importantly improve local control in patients with potentially compromised margi
Recurrence and Survival Outcomes After Anatomic Segmentectomy Versus Lobectomy for Clinical Stage I Non–Small-Cell Lung Cancer: A Propensity-Matched Analysis
August 9, 2014
This single-institution retrospective study used propensity score matching to compare long-term outcomes of anatomic segmentectomy vs lobectomy for early stage non-small cell lung cancer. A total of 312 pts were matched in each group. Locoregional and overall recurrence rates were similar between the groups. Freedom from recurrence (70% for segme