Researchers at the Washington University School of Medicine recently revealed that surgery may be beneficial for patients with advanced metastatic non-small cell lung cancer (NSCLC) undergoing multimodality treatment in terms of survival rates. The study was published in The Annals of Thoracic Surgery journal and is entitled “Role for Surgical Resection in the Multidisciplinary Treatment of Stage IIIB Non–Small Cell Lung Cancer”.
NSCLC is the most common type of lung cancer corresponding to approximately 85% of all lung cancers diagnosed. Patients with advanced stage IIIB NSCLC typically have the tumor spread to the lymph nodes or other organs close to the lungs such as the heart, trachea or esophagus. The 5-year survival rate of stage IIIB NSCLC patients is only of 10%.
In terms of treatment, “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,” said the study’s lead author Dr. Matthew J. Bott in a news release. In this study, the team wanted to evaluate the impact of surgical intervention in this patient population.
Researchers analyzed data from the National Cancer Database on 9,173 stage IIIB NSCLC patients who had been submitted to combination treatment (multimodality therapy) in the period between 1998 and 2010. Patients were divided into two groups according to the therapy employed: 7,459 patients treated with combined chemotherapy and radiation (CR group), and 1,714 patients treated with chemotherapy, radiation, and surgery (CRS group) to remove part or the entire lung.
The research team found that patients in the CRS group had a median overall survival of 25.9 months in comparison to 16.3 months in patients of the CR group, a difference of more than 9 months. The factors linked to an improved overall survival were found to be a younger age, female sex, small tumor size and surgical resection.
The team concluded that patients with advanced metastatic NSCLC may benefit from surgical resection of the lung together with chemotherapy and radiation in a multimodality therapy.
“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,” concluded Dr. Bott. The authors are, however, cautious and suggest that more detailed studies should be conducted before establishing the inclusion of surgery in the multimodality treatment regimen.