Treatment of stage I non–small cell lung cancer: What's trending?

Abstract

Although the number of stage I non-small cell lung cancer cases continues to increase, lobectomy rates are decreasing while sublobar resection and stereotactic body radiation therapy rates are increasing. Although the increasing popularity of alternative therapies to lobectomy for treatment of stage I non-small cell lung cancer should allow more patients to undergo treatment, we did not observe this trend in the data.

Substantial nation-wide improvement in lung cancer relative survival in Norway from 2000 to 2016

“…The largest survival change probably concerns patients with localised disease ineligible for surgery [19]. A substantial proportion of these patients are now offered SBRT [20,21], accounting for 12% of all newly diagnosed patients with lung cancer in 2016.…”

Long-Term Results for Clinical Stage IA Lung Cancer: Comparing Lobectomy and Sublobar Resection

“…However, sublobar resection is widely used in practice. Reviews of the National Cancer Data Base (NCDB) and Surveillance, Epidemiology, and End Results database estimate 17%−31% of patients have undergone sublobar resection [2,3]. Sublobar resection is often reserved for higher-risk patients [3–5].…”

One in every 14 patients with early-stage lung cancer is not being treated!

“…8 One would hope that this increase in treatment options would decrease the number of untreated patients. In contradiction, the findings of McMurry and colleagues 9 in the current issue of the Journal demonstrate a stable population of patients with early-stage lung cancer who remain untreated despite advances.…”