PMID- 35307270
OWN - NLM
STAT- MEDLINE
DCOM- 20220517
LR  - 20220520
IS  - 1938-0690 (Electronic)
IS  - 1525-7304 (Linking)
VI  - 23
IP  - 3
DP  - 2022 May
TI  - Active Surveillance for Early Stage Lung Cancer.
PG  - 226-235
LID - S1525-7304(22)00012-2 [pii]
LID - 10.1016/j.cllc.2022.01.001 [doi]
AB  - OBJECTIVES: Data describing outcomes for patients with early stage lung cancer 
      who undergo expectant management is lacking, despite evidence of a sub-population 
      with indolent malignancies. We used the National Cancer Data Base (NCDB) to 
      identify factors associated with active surveillance for early stage lung cancer. 
      Additionally, we sought to describe outcomes of three different care plans: 
      active surveillance, no treatment, and Stereotactic Body Radiation Therapy 
      (SBRT). METHODS: Patients diagnosed in 2010 to 2017 with early stage lung cancer 
      who underwent active surveillance, no treatment, and SBRT were retrospectively 
      identified in the NCDB. Multinomial logistic regression was used to assess care 
      plan selection. Kaplan Meier analysis was used to assess overall survival (OS). 
      RESULTS: We identified 30,107 patients that met our inclusion criteria: 838 (3%) 
      underwent active surveillance, 6388 patients (21%) received no treatment, and 
      22,881 (76%) underwent SBRT. Black race (relative risk ratio (RRR): 1.66) and 
      older age (RRR: 1.02) were significant positive predictors of active surveillance 
      selection. Conversely, higher tumor stage (RRR: 0.26) and squamous cell carcinoma 
      (RRR: 0.35) were significant negative predictors of active surveillance 
      selection. Kaplan Meier analysis revealed a longer median OS associated with 
      active surveillance compared to no treatment at 49.3 months versus 26.5 months, 
      respectively. SBRT OS was 43.1 months. CONCLUSIONS: We identified a population of 
      lung cancer patients who underwent expectant management with favorable outcomes. 
      Additionally, we identified factors associated with active surveillance 
      selection. The selection of active surveillance over no treatment was associated 
      with significantly longer OS.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - Payne, Ryan G
AU  - Payne RG
AD  - University of Massachusetts Medical School, Worcester, MA.
FAU - Anker, Christopher J
AU  - Anker CJ
AD  - University of Vermont Larner College of Medicine, Burlington, VT.
FAU - Sprague, Brian L
AU  - Sprague BL
AD  - University of Vermont Larner College of Medicine, Burlington, VT.
FAU - No, Hyunsoo J
AU  - No HJ
AD  - Stanford University, Radiation Oncology, Stanford, CA.
FAU - Lin, Steven H
AU  - Lin SH
AD  - University of Texas MD Anderson Cancer Center, Houston, TX.
FAU - Lester-Coll, Nataniel H
AU  - Lester-Coll NH
AD  - University of Vermont Larner College of Medicine, Burlington, VT. Electronic 
      address: nataniel.lester-coll@med.uvm.edu.
LA  - eng
PT  - Journal Article
DEP - 20220212
PL  - United States
TA  - Clin Lung Cancer
JT  - Clinical lung cancer
JID - 100893225
SB  - IM
MH  - *Carcinoma, Non-Small-Cell Lung/pathology
MH  - Humans
MH  - *Lung Neoplasms/diagnosis/therapy
MH  - Neoplasm Staging
MH  - *Radiosurgery/adverse effects
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Watchful Waiting
OTO - NOTNLM
OT  - Cancer outcomes
OT  - Expectant Management
OT  - National Cancer Data Base
OT  - Non-Small Cell Lung Cancer
OT  - Stereotactic Body Radiation Therapy
EDAT- 2022/03/22 06:00
MHDA- 2022/05/18 06:00
CRDT- 2022/03/21 05:33
PHST- 2021/09/24 00:00 [received]
PHST- 2021/11/30 00:00 [revised]
PHST- 2022/01/18 00:00 [accepted]
PHST- 2022/03/22 06:00 [pubmed]
PHST- 2022/05/18 06:00 [medline]
PHST- 2022/03/21 05:33 [entrez]
AID - S1525-7304(22)00012-2 [pii]
AID - 10.1016/j.cllc.2022.01.001 [doi]
PST - ppublish
SO  - Clin Lung Cancer. 2022 May;23(3):226-235. doi: 10.1016/j.cllc.2022.01.001. Epub 
      2022 Feb 12.