Aggressive Surgery Increases Lung Cancer Patients’ Long-term Survival, Study Shows

Aggressive Surgery Increases Lung Cancer Patients’ Long-term Survival, Study Shows

A lung surgery called lobectomy increases early lung cancer patients’ long-term survival better than less aggressive surgical approaches or radiation, a study shows.

A lobectomy involves removing portions of lungs called lobes. The right lung has three lobes and the left two.

The study, “Stereotactic Body Radiation Therapy Versus Surgery for Early Lung Cancer Among US Veterans,” was published in the journal The Annals of Thoracic Surgery.

“Our data suggest that the more aggressively we treat early lung cancer, the better the outcome,” Dr. Alex Bryant, a researcher at the University of California at San Diego, said in a press release. “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,” said Bryant, the study’s lead author.

Researchers analyzed patients with early stage non-small cell lung cancer (NSCLC) using the Veterans Affairs Informatics and Computing Infrastructure.

The database on veterans’ medical treatment includes such information as their lung function before surgery, their smoking history, and their tumor staging — whether a tumor is and how large it is. This type of information is not often available but is of great importance, researchers said.

Researchers looked at the outcomes of 4,069 patients who had one of three types of treatment. Most of them, 2,986, had a lobectomy. Sixty hundred thirty-four had a less extensive surgery, sublobar resection. And 449 had stereotactic body radiation therapy, which  zaps a tumor with high doses of radiation over one to two weeks.

Lobectomy patients had the highest five-year survival rate – 70 percent. Fifty-six percent of the group with less aggressive surgery survived. The figure was 44 percent for the radiation group.

Another important finding was that the long-term risk of radiation group members dying of cancer was 45 percent higher than the lobectomy group’s.

The risk of death in the short term was higher in patients who had either surgery than from radiation. But over time surgery patients’ risk decreased, particularly those who had a lobectomy.

“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,” Bryant said.

The study also showed that doctors administered more radiation therapy to patients as time went by. The team said some patients become too sick for surgery, making radiation a better option.

When patients can withstand surgery, the better option is lobectomy, the study showed.

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

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