2024 World Conference on Lung Cancer (WCLC) - Posters-P2.07B.04 Comparative Effectiveness of Sub-Lobar Resection vs Lobectomy for Medically Operable Stage I NSCLC: A VACCR Analysis

P2.07B.04 Comparative Effectiveness of Sub-Lobar Resection vs Lobectomy for Medically Operable Stage I NSCLC: A VACCR Analysis

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The study titled "Comparative Effectiveness of Sub-lobar Resection versus Lobectomy for Medically Operable Stage I NSCLC: A VACCR Analysis" examines the outcomes of two surgical procedures for early-stage non-small cell lung cancer (NSCLC): lobectomy and sub-lobar resection. Conducted by researchers from the Duke University School of Medicine and Durham VA Health Care System, the study analyzes a cohort of 1,355 patients diagnosed with cT1N0M0 NSCLC between 2000 and 2020.<br /><br />The research investigates whether sub-lobar resection could be a viable alternative to lobectomy, especially for patients deemed medically operable but with tumors less than 3 cm. The study finds that there is no significant difference in overall survival (OS) and lung cancer-specific survival (LCSS) between the two surgical methods based on multivariable analysis. The hazard ratio (HR) for sub-lobar resection versus lobectomy is 1.17 (with a confidence interval of 0.99-1.40) for overall survival and 1.06 (0.81-1.40) for lung cancer-specific survival, indicating no statistical significance.<br /><br />Key findings highlight that Diffusing Capacity of the Lung for Carbon Monoxide (DLCO) is a more critical predictor of patient survival than Forced Expiratory Volume in 1 Second (FEV1). This underlines the importance of DLCO in pre-surgical evaluations. The results suggest that sub-lobar resection could broaden the treatment options for patients with tumors under 3 cm, irrespective of the tumor's location within the lung.<br /><br />The study advocates for further research to explore the prognostic utility of DLCO in surgical candidacy and to validate the effectiveness of sub-lobar resection in a wider demographic of early-stage NSCLC patients. These findings could potentially alter clinical guidelines, offering less invasive alternatives to a broader spectrum of patients.

Asset Subtitle

Michael Snider

Meta Tag

Speaker Michael Snider

Topic Early-Stage NSCLC

Keywords

NSCLC

sub-lobar resection

lobectomy

surgical outcomes

Duke University

DLCO

FEV1

lung cancer survival

early-stage cancer

clinical guidelines