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Multimodality treatment for metastatic lung cancer with surgery may improve survival rates

Surgery may benefit select group of patients; multidisciplinary evaluation is critical to success

2015-06-10
(Press-News.org) Chicago, June 10, 2015 - Patients diagnosed with an advanced form of metastatic non-small cell lung cancer (NSCLC) may benefit from surgical resection (removal of all or part of the lung) in combination with chemotherapy and radiation therapy, according to an article in the June 2015 issue of The Annals of Thoracic Surgery.

Key points

Patients diagnosed with stage IIIB NSCLC may benefit from multimodality treatment that combines surgical resection in combination with chemotherapy or radiation therapy. Surgery should be added to the treatment regimen only for carefully selected patients. The researchers said multidisciplinary evaluation of patients is critical to successful treatment, and more research needs to be conducted before definitive guidelines can be established.

"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 Matthew J. Bott, MD, from Washington University in St. Louis, who led the study.

In stage IIIB NSCLC, the tumor usually has spread to lymph nodes or invaded other organs around the lungs, such as the heart, esophagus, or trachea. Patients with stage IIIB NSCLC have a 5-year overall survival rate of only 10%.

Dr. Bott and colleagues evaluated data from the National Cancer Database on 9,173 patients with stage IIIB NSCLC who had undergone combination treatment (multimodality therapy) between 1998 and 2010.

Patients were split into two groups: 7,459 patients who were treated with combined chemotherapy and radiation (CR group), and 1,714 patients who were treated with chemotherapy, radiation, and surgery (CRS group) in any order.

The researchers found that the median overall survival was more than 9 months longer in the CRS group than in the CR group (25.9 months vs. 16.3 months, respectively).

Because the patients in the CRS group tended to be younger, Caucasian, and have slightly smaller tumors than the patients in the CR group, Dr. Bott cautioned that surgery should be added to the treatment regimen only for carefully selected patients and that more research needs to be conducted before definitive guidelines can be established.

"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," said Dr. Bott.

INFORMATION:

Notes for editors Role for Surgical Resection in the Multidisciplinary Treatment of Stage IIIB Non-Small Cell Lung Cancer
doi:10.1016/j.athoracsur.2015.02.033 The Annals of Thoracic Surgery published by Elsevier. http://www.sciencedirect.com/science/article/pii/S0003497515002416

Full text of the article is available to credentialed journalists upon request; contact Cassie McNulty cmcnulty@sts.org at +1 312 202 5865

About The Annals of Thoracic Surgery The Annals of Thoracic Surgery is the official journal of STS and the Southern Thoracic Surgical Association. Founded in 1964, The Society of Thoracic Surgeons is a not-for-profit organization representing more than 6,800 cardiothoracic surgeons, researchers, and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society's mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.

About Elsevier Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions -- among them ScienceDirect, Scopus, Elsevier Research Intelligence and ClinicalKey -- and publishes over 2,500 journals, including The Lancet and Cell, and more than 33,000 book titles, including a number of iconic reference works. Elsevier is part of RELX Group plc, a world-leading provider of information solutions for professional customers across industries. http://www.elsevier.com



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[Press-News.org] Multimodality treatment for metastatic lung cancer with surgery may improve survival rates
Surgery may benefit select group of patients; multidisciplinary evaluation is critical to success