2024 World Conference on Lung Cancer (WCLC) - Posters-P2.07B.09 Real-World Validation for Impact of Sublobar Resection Over Lobectomy on Lung Cancer Survival and Frailty Using SEER-Medicare

P2.07B.09 Real-World Validation for Impact of Sublobar Resection Over Lobectomy on Lung Cancer Survival and Frailty Using SEER-Medicare

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Lung cancer (LC) commonly affects older adults, with the median age at diagnosis being 71 years. Lobectomy is the standard treatment for early-stage lung cancer, but it poses higher risks of complications for older patients. Recent Phase-3 trials by Altorki (2023) demonstrated that sublobar resection is not inferior to lobectomy concerning survival in patients with early-stage non-small cell lung cancer (NSCLC). However, these trials often include biases due to the selection of younger participants, which may limit their broader applicability.<br /><br />A study leveraging SEER-Medicare data (2006-2019) used real-world evidence to validate these findings, particularly focusing on survival and frailty in NSCLC patients. The study employed a method called target trial emulation, minimizing biases related to selection and time, enhancing the reliability of the results. This research was backed by the National Institute on Aging (NIA) under an NIH award.<br /><br />The study results confirmed that sublobar resection provides comparable survival rates to lobectomy in early-stage NSCLC patients. Notably, patients who underwent sublobar resection were significantly less likely to develop frailty, a geriatric syndrome indicative of aging. This finding suggests that opting for sublobar resection could promote healthy aging and reduce cancer burden in older LC patients.<br /><br />The study further aims to evaluate long-term impacts of sublobar resection versus lobectomy on frailty risk among patients aged 65 and above who were non-frail at diagnosis. The results showed a reduction in frailty onset among patients undergoing sublobar resection. These insights emphasize the importance of considering less invasive surgical options for older adults with LC to enhance both survival and quality of life.

Asset Subtitle

Eunji Choi

Meta Tag

Speaker Eunji Choi

Topic Early-Stage NSCLC

Keywords

lung cancer

older adults

lobectomy

sublobar resection

non-small cell lung cancer

survival

frailty

target trial emulation

SEER-Medicare data

healthy aging