Alexander Lam1, Emi J Yoshida2, Kevin Bui3, Dayantha Fernando3, Kari Nelson3, Nadine Abi-Jaoudeh3. 1. Department of Radiological Sciences, University of California, Irvine, School of Medicine, 101 The City Drive South, Orange, CA 92868. Electronic address: Alex.Huynh.Lam@gmail.com. 2. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California. 3. Department of Radiological Sciences, University of California, Irvine, School of Medicine, 101 The City Drive South, Orange, CA 92868.
Abstract
PURPOSE: To compare overall survival (OS) after radiofrequency (RF) ablation and stereotactic body radiotherapy (SBRT) at high-volume centers in patients with early-stage non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Cases in the National Cancer Database of stage 1a and 1b NSCLC treated with primary RF ablation or SBRT from 2004 to 2014 were included. Patients treated at low-volume centers, defined as facilities below the 95th percentile in volume of cases performed, were excluded. Outcomes measured include OS and rate of 30-day readmission. The Kaplan-Meier method was used to estimate OS. The log-rank test was used to compare survival curves. Propensity score matched cohort analysis was performed. P < .05 was considered statistically significant. RESULTS: The final cohort comprised 4,454 cases of SBRT and 335 cases of RF ablation. Estimated median survival and follow-up were 38.8 months and 42.0 months, respectively. Patients treated with RF ablation had significantly more comorbidities (P < .001) and higher risk for an unplanned readmission within 30 days (hazard ratio = 11.536; P < .001). No difference in OS for the unmatched groups was found on multivariate Cox regression analysis (P = .285). No difference was found in the matched groups with 1-, 3-, and 5-year OS of 85.5%, 54.3%, and 31.9% in the SBRT group vs 89.3%, 52.7%, and 27.1% in the RF ablation group (P = .835). CONCLUSIONS: No significant difference in OS was seen between patients with early-stage NSCLC treated with RF ablation and SBRT. Published by Elsevier Inc.
PURPOSE: To compare overall survival (OS) after radiofrequency (RF) ablation and stereotactic body radiotherapy (SBRT) at high-volume centers in patients with early-stage non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Cases in the National Cancer Database of stage 1a and 1b NSCLC treated with primary RF ablation or SBRT from 2004 to 2014 were included. Patients treated at low-volume centers, defined as facilities below the 95th percentile in volume of cases performed, were excluded. Outcomes measured include OS and rate of 30-day readmission. The Kaplan-Meier method was used to estimate OS. The log-rank test was used to compare survival curves. Propensity score matched cohort analysis was performed. P < .05 was considered statistically significant. RESULTS: The final cohort comprised 4,454 cases of SBRT and 335 cases of RF ablation. Estimated median survival and follow-up were 38.8 months and 42.0 months, respectively. Patients treated with RF ablation had significantly more comorbidities (P < .001) and higher risk for an unplanned readmission within 30 days (hazard ratio = 11.536; P < .001). No difference in OS for the unmatched groups was found on multivariate Cox regression analysis (P = .285). No difference was found in the matched groups with 1-, 3-, and 5-year OS of 85.5%, 54.3%, and 31.9% in the SBRT group vs 89.3%, 52.7%, and 27.1% in the RF ablation group (P = .835). CONCLUSIONS: No significant difference in OS was seen between patients with early-stage NSCLC treated with RF ablation and SBRT. Published by Elsevier Inc.
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