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A national analysis of wedge resection versus stereotactic body radiation therapy for stage IA non–small cell lung cancer  Babatunde A. Yerokun, MD, Chi-Fu.

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Presentation on theme: "A national analysis of wedge resection versus stereotactic body radiation therapy for stage IA non–small cell lung cancer  Babatunde A. Yerokun, MD, Chi-Fu."— Presentation transcript:

1 A national analysis of wedge resection versus stereotactic body radiation therapy for stage IA non–small cell lung cancer  Babatunde A. Yerokun, MD, Chi-Fu Jeffrey Yang, MD, Brian C. Gulack, MD, Xuechan Li, MS, Michael S. Mulvihill, MD, Lin Gu, MS, Xiaofei Wang, PhD, David H. Harpole, MD, Thomas A. D'Amico, MD, Mark F. Berry, MD, Matthew G. Hartwig, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 154, Issue 2, Pages e4 (August 2017) DOI: /j.jtcvs Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Overlap histogram for propensity score matching of the overall cohort. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Kaplan-Meier–adjusted survival of patients with clinical-stage IA NSCLC. Overall survival of matched groups is shown. HR, Hazard ratio; CI, confidence interval; KM Est, Kaplan-Meier estimate; REF, reference group; SBRT, stereotactic body radiotherapy. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Center-level comparison of SBRT to wedge resection. Scatter plot of centers stratified by their center ratio of SBRT/wedge. First-quartile centers predominately used wedge resection, whereas fourth-quartile centers predominately used SBRT. Centers with either all SBRT patients, all wedge resection patients, or with less than 5 patients were excluded. Quartiles were compared using a ratio of observed mortality to expected mortality with an O/E ≤ 1 indicating similar or better performance than expected and an O/E > 1 indicating worse performance than expected. Depicted is center 3-year mortality O/E ratios. O/E, Observed to expected; %SBRT, percent stereotactic body radiotherapy use. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

5 Figure E1 Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) diagram. NSCLC, Non–small cell lung cancer; SBRT, stereotactic body radiotherapy; BED, biologically effective dose. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

6 Figure E2 Age > 80 years subgroup analysis. Kaplan-Meier–adjusted survival of patients with clinical-stage IA NSCLC. Overall survival of matched groups is shown. HR, Hazard ratio; CI, confidence interval; KM Est, Kaplan-Meier estimate; REF, reference group; NE, nonestimable; SBRT, stereotactic body radiotherapy. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

7 Figure E3 Charlson-Deyo score ≥ 2 subgroup analysis. Kaplan-Meier–adjusted survival of patients with clinical-stage IA NSCLC. Overall survival of matched groups is shown. HR, Hazard ratio; CI, confidence interval; KM Est, Kaplan-Meier estimate; REF, reference group; SBRT, stereotactic body radiotherapy. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

8 Figure E4 Center-level comparison of SBRT with wedge resection. Scatterplot is shown of centers stratified by their center ratio of SBRT/wedge. First-quartile centers predominately used wedge resection, whereas fourth-quartile centers predominately used SBRT. Centers with either all SBRT patients, all wedge resection patients, or with less than 5 patients were excluded. Quartiles were compared with a ratio of observed mortality to expected mortality, with an O/E ≤ 1 indicating similar or better performance than expected and an O/E > 1 indicating worse performance than expected. Depicted is center 1-month mortality O/E ratios. O/E, Observed to expected; %SBRT, percent stereotactic body radiotherapy use. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

9 Figure E5 Center-level comparison of SBRT with wedge resection. Scatter plot is shown of centers stratified by their center ratio of SBRT/wedge. First-quartile centers predominately used wedge resection, whereas fourth-quartile centers predominately used SBRT. Centers with either all SBRT patients, all wedge resection patients, or with less than 5 patients were excluded. Quartiles were compared with a ratio of observed mortality to expected mortality with an O/E ≤ 1 indicating similar or better performance than expected and an O/E > 1 indicating worse performance than expected. Depicted is center 1-year mortality O/E ratios. O/E, Observed to expected; %SBRT, percent stereotactic body radiotherapy use. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

10 Figure E6 Center-level comparison of SBRT with wedge resection. Scatter plot is shown of centers stratified by their center ratio of SBRT/wedge. First-quartile centers predominately used wedge resection, whereas fourth-quartile centers predominately used SBRT. Centers with either all SBRT patients, all wedge resection patients, or with less than 5 patients were excluded. Quartiles were compared with a ratio of observed mortality to expected mortality with an O/E ≤ 1 indicating similar or better performance than expected and an O/E > 1 indicating worse performance than expected. Depicted is center 2-year mortality O/E ratios. O/E, Observed to expected; %SBRT, percent stereotactic body radiotherapy use. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

11 Overall survival for operable patients with clinical-stage IA non–small cell lung cancer.
The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

12 Video 1 Oral presentation of the paper from the AATS 2016 Annual Meeting. Video available at: The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

13 The Journal of Thoracic and Cardiovascular Surgery 2017 154, 675-686
The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

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