In a new study entitled “Role for Surgical Resection in the Multidisciplinary Treatment of Stage IIIB Non-Small Cell Lung Cancer,” authors performed a retrospective analysis on the benefits of adding surgery to chemotherapy and radiotherapy regimens in patients with advanced non-small cell lung cancer. Their results suggest that some patients might benefit from this multimodality therapy when compared to chemotherapy/radiotherapy alone. The study was published in The Annals of Thoracic Surgery.
Patients in stage III B of non-small cell lung cancer (NSCLC) have a poor prognosis (5-year overall survival rate is 10%) since the tumor is no longer confined and cancer cells already metastasized to other body parts (colonizing other organs around the lungs, including heart, esophagus or trachea) via the lymph nodes. This is why, “Currently, most patients with stage IIIB non-small cell lung cancer are not candidates for surgery; instead, they are treated with chemotherapy and radiation only,” as explained the study lead author, Matthew J. Bott, MD, from Washington University, St. Louis.
In this new study, authors evaluated if patients with stage III B NSCLC benefited from a multi modality therapy, i.e., a combination of both surgery and chemotherapy/radiotherapy. To this end, the team performed a retrospective analyses on data of 9,173 patients with stage IIIB NSCLC retrieved from the National Cancer Database. Patients data was divided into those who received combined chemotherapy and radiation and those who were treated with a multimodality therapy, thus including chemotherapy, radiation and surgery. Authors observed that the median overall survival was significantly higher in the multimodality therapy group, with patients living at least 9 months more, then the chemotherapy and radiation group (specifically, 25.9 months vs. 16.3 months, respectively).
The authors noted, however, that patients in the multimodality therapy group were often younger, Caucasian and with smaller tumors. Thus, surgery may be integrated as part of a multimodality therapy but in highly selected patients with stage IIIB NSCLC, the authors noted. Additional studies are thus required to fully understand and evaluate these findings, so that appropriated guidelines can be established in a near future.
“We hope that our research reinvigorates discussion regarding the optimal treatment of these patients and leads to greater multidisciplinary evaluation of treatment options, with increased participation of thoracic surgeons in the decision-making process,” commented Dr. Bott.