Breaking News
February 23, 2018 - Patients who achieve short-term weight loss before bariatric surgery have better outcomes
February 23, 2018 - Beetroot may reduce kidney failure risk after heart x-ray, research reveals
February 23, 2018 - Sleep disruptions in menopause correlated with hot flashes and depression
February 23, 2018 - Scientists discover new treatment approach to curb severe myocarditis
February 23, 2018 - ‘Click chemistry’ approach may improve disease-fighting properties of drugs
February 23, 2018 - NIGHTSEA and EMS team up to offer KEY Award in fluorescence stereo microscopy
February 23, 2018 - Tobacco Kills, No Matter How It’s Smoked: Study
February 23, 2018 - Q&A: Avindra Nath, MD | Medpage Today
February 23, 2018 - Adherence to sleep apnea treatment affects risk of hospital readmission
February 23, 2018 - Zika virus could be alternative for treatment of aggressive brain cancer
February 23, 2018 - Carbon monoxide enhances efficacy of antibiotic against stomach infection
February 23, 2018 - MSD and Ferring Pharmaceuticals Complete Largest Ever Clinical Trial in Postpartum Haemorrhage
February 23, 2018 - Portable ultrasound can help better detect fluid in the lungs of patients with end-stage kidney disease
February 23, 2018 - Postnova AF2000 system offers reliable characterization of trace metal colloid distribution in the environment
February 23, 2018 - Pioneering study may pave way for effective painkillers to treat neuropathic pain
February 23, 2018 - Research opens up new avenue to minimize risks of transplants
February 22, 2018 - Cabozantinib Active in Advanced Thyroid Cancer
February 22, 2018 - Polluted air may pollute our morality
February 22, 2018 - New data from VOYAGE 2 trial shows promising results for Janssen’s guselkumab treatment
February 22, 2018 - Bank loans signed in the hospital leave patients vulnerable
February 22, 2018 - Researchers identify new nanostructure inside sperm tails
February 22, 2018 - Catheter-based procedure increases treatment options for mitral valve disease
February 22, 2018 - Sage Therapeutics Receives FDA Breakthrough Therapy Designation for SAGE-217 for the Treatment of Major Depressive Disorder
February 22, 2018 - Larger Endocarditis Vegetations More Likely to Embolize, Kill
February 22, 2018 - Parenting behavior in adoptive families
February 22, 2018 - Researchers discover new weakness in sleeping sickness parasites
February 22, 2018 - Research project aims to find new ways to identify and treat most aggressive brain cancers
February 22, 2018 - Researchers explore how people with Alzheimer’s disease use end-of-life medical services
February 22, 2018 - Stroke survivors and carers feel marginalized due to lack of support from primary care
February 22, 2018 - Neuroscientists discover novel mechanism of action behind schizophrenia
February 22, 2018 - After shooting, ‘honor how kids want to deal with their feelings’
February 22, 2018 - U.S., EU and Japan Health Authorities Accept Regulatory Submissions For Review Of Pfizer’s Third-generation ALK Inhibitor Lorlatinib
February 22, 2018 - At-Home Genetic Test Might Change Medicine
February 22, 2018 - Many second hand plastic toys could pose a risk to children’s health, study suggests
February 22, 2018 - Study shows that two different brain systems cooperate during learning
February 22, 2018 - Liquefied brain tissue after stroke may harm surviving brain, UA study finds
February 22, 2018 - New intervention improves communication behaviors in couples affected by dementia
February 22, 2018 - Clinical trial shows safety of promising TSRI stroke drug
February 22, 2018 - Researchers discover new interaction mechanism of unstructured proteins
February 22, 2018 - A Patient’s Journey: Can I Kill the Glucose Monster?
February 22, 2018 - The Problem That Piles Up
February 22, 2018 - Kids can roll up their sleeves—again—for mumps protection
February 22, 2018 - Scientists find significant amounts of toxic metals in e-cigarette vapors
February 22, 2018 - 3D Signatures reports positive results of new Telo-HL test for Hodgkin’s lymphoma
February 22, 2018 - Scientists reveal development of improved medicine to fight addiction
February 22, 2018 - USC-led researchers release dataset of brain scans from stroke patients
February 22, 2018 - Antibiotic-producing bacterium releases more metabolites than assumed
February 22, 2018 - Flu Season Shows First Signs of Slowing
February 22, 2018 - Nonstick Chemicals May Disrupt Metabolic Function in Women
February 22, 2018 - Calcium may play a role in the development of Parkinson’s disease
February 22, 2018 - Scientists visualize insulin receptor activation for the first time
February 22, 2018 - UC San Diego Health now offers new treatment option for people with refractory epilepsy
February 22, 2018 - First African child vaccinated with new typhoid conjugate vaccine
February 22, 2018 - BetterYou named as ‘Most Innovative Brand’ at FGB Awards 2018
February 22, 2018 - Assaults Among Young People Fall to Lowest Rate in 15 Years
February 22, 2018 - What do you know about Parkinson’s disease?
February 22, 2018 - Researchers discover five new genetic changes that may increase pancreatic cancer risk
February 22, 2018 - Gout medication may help improve heart function in adult patients
February 22, 2018 - Bioactive compound limits collateral damage in the kidneys after heart attack
February 22, 2018 - Study reveals HCT as effective treatment for NHL patients regardless of age
February 22, 2018 - Father’s age can affect offspring lifespan, mice study shows
February 22, 2018 - Opiant Pharmaceuticals Announces Publication of New Pre-Clinical Data Supporting Potential of OPNT005 as a Heroin Vaccine
February 22, 2018 - Make the Diagnosis: Strange Rash Surfaces
February 22, 2018 - Isolated sulfite oxidase deficiency – Genetics Home Reference
February 22, 2018 - Scientists identify weight loss ripple effect
February 22, 2018 - Smoking at record lows in New York
February 22, 2018 - Scientists pinpoint fertility hormone that could support early pregnancy
February 22, 2018 - Aggressive cancer stem cells can now be isolated successfully in a scientific breakthrough
February 22, 2018 - Researchers find high risk of suicide among unaccompanied refugee minors
February 22, 2018 - Protein levels linked to posture and gait problems in Parkinson’s
February 22, 2018 - Biomedical engineers create 3D hydrogel scaffolds  to transform cells into muscle
February 22, 2018 - Study employs novel approach to uncover new biomarker for CHD
February 22, 2018 - Study finds strong connection between midwifery and birth outcomes
February 22, 2018 - Verastem Submits NDA to FDA for Duvelisib for the Treatment of Patients With Relapsed or Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma and Follicular Lymphoma
February 22, 2018 - Low BP Associated With Risk in HFpEF
February 22, 2018 - More U.S. women obese before pregnancy, experts sound the alarm
February 22, 2018 - Study aims to examine effects of PTSD symptoms in police officers
February 22, 2018 - Study reveals increased disease risk after early heart surgery
February 22, 2018 - Women with Type 1 diabetes come across unique challenges
February 22, 2018 - Researchers target abnormal epigenetic mechanisms involved in childhood cancers
‘Aggressive’ surgery for early stage lung cancer provides better outcomes

‘Aggressive’ surgery for early stage lung cancer provides better outcomes

image_pdfDownload PDFimage_print

Patients with early stage lung cancer live longer when they receive a lobectomy- the most common type of operation for the disease- rather than a less extensive operation or radiation treatment, according to a study published online today in The Annals of Thoracic Surgery.

“Our data suggest that the more aggressively we treat early lung cancer, the better the outcome,” said lead author Alex Bryant, BS, of the School of Medicine at the University of California, San Diego. “This study is one of the best-powered and detailed analyses to date and suggests that lobectomy is still the preferred treatment of this disease for most patients.”

Using the Veterans Affairs Informatics and Computing Infrastructure (VINCI), Bryant, James D. Murphy, MD, and colleagues identified patients who were diagnosed with early stage non-small cell lung cancer (NSCLC) between 2006 and 2015, and who were treated with either surgery or radiation. In all, 4,069 patients were included: 73% (2,986) underwent lobectomy, 16% (634) received a sublobar resection, and 11% (449) received stereotactic body radiation therapy (SBRT). Lobectomy is the removal of an entire lobe of the lung; sublobar resection is a less extensive operation that includes wedge and segmental resections; SBRT delivers very high doses of radiation over a short period of time (typically 1-2 weeks), precisely targeting the tumor.

The researchers described VINCI as an “extremely rich source of health information” from which they were able to gather detailed data related to a large, nationwide group of veterans. The database includes patient-specific data related to preoperative pulmonary function, smoking history, and tumor staging. Factors such as these are often not available and have not been consistently addressed in previous studies, which sets this study apart, according to Bryant.

In their analyses, the researchers found that the 5-year incidence of cancer death was lowest in the lobectomy group at 23%, with the sublobar group at 32%, and SBRT patients at 45%. SBRT also was associated with a 45% increased risk of cancer death compared with lobectomy.

Surgery, though, was not without risks. The study showed that both surgical groups had higher immediate mortality compared to radiation due to operative risks. The 30-day mortality was 1.9% for lobectomy, 1.7% for sublobar resection, and 0.5% for SBRT. But as time went on and with longer follow-up, the surgery groups demonstrated superiority to SBRT, with long-term survival favoring surgery, especially lobectomy, over radiation. The 5-year overall survival rate for lobectomy patients was 70%, followed by the sublobar resection group at 56%, and SBRT at 44%.

“Our data suggest that the higher operative risks of surgery are more than offset by improved survival in the months and years after treatment, particularly for lobectomy,” said Bryant.

Increased Use of SBRT

The study also showed that the use of SBRT increased throughout the study period, accounting for 2% of all treatments in 2006 and 19% in 2015. Bryant explained that for patients who are too sick to tolerate a major operation like lobectomy, SBRT makes sense and has become an increasingly common option. Less extensive surgeries, such as sublobar resections, also remain a possibility, but there are ongoing concerns about a higher risk of tumor recurrences, he said. As a result, lobectomy remains the standard treatment for early lung cancer in patients who can tolerate a major surgical procedure.

“The public should be aware that lung cancer – even when caught at a very early stage – is a serious diagnosis and deserves aggressive treatment,” said Bryant.

Lung cancer is the leading cause of cancer death, with more people dying of lung cancer than of colon, breast, and prostate cancers combined. NSCLC is the most common type of lung cancer, accounting for 80% to 85% of all lung cancer diagnoses, according to the American Cancer Society (ACS). ACS estimates that more than 222,500 Americans will be diagnosed with lung cancer this year, and more than 155,000 lung cancer patients will die. About 14% of all new cancers are lung cancers.

Tagged with:

About author

Related Articles