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  • br those who underwent SBRT and to years for those

    2020-03-17

    
    those who underwent SBRT and 68 to 78 years for those who underwent surgery. Gender variations were noted to be significantly different among studies, with 4 studies, primarily from military institutions or registries, reporting
    study populations comprising less than 10% female participants.25,26,33,46 SBRT regimens varied in dosage
    and fractions among centers and within each institution, depending on the location, size, and type of the tumor. When resection type was specified, lobectomies accounted for more than 60% of resections in the studies selected for meta-analysis, with sublobar resections accounting for the majority of the remaining surgical procedures. The use of video-assisted thoracoscopic
    surgery (VATS) varied among reports, with 4 studies only reporting on VATS procedures.16,33,37,43 A summary of
    histopathologic details and clinical staging for the matched SBRT and surgical patients is presented in Table 4. A summary of these details for unmatched patients is presented in Table E2. In brief, adenocarcinoma and squamous cell carcinoma were the most common types of NSCLC. Up to 70% of patients who underwent SBRT did not have a pretreatment pathologic diagnosis of NSCLC.36
    The Journal of Thoracic and Cardiovascular Surgery c Volume 157, Number 1 365
    Thoracic: Lung Cancer: Review Cao et al
    THOR
    TABLE 2. Summary of covariates used for propensity score matching in comparative studies on stereotactic body CAY10683 therapy versus surgical resection for early-stage non–small cell lung cancer
    Patient characteristics
    Preoperative risk factors
    Tumor characteristics
    Home
    Study
    Age Sex Race Education Income Insurance Geography CCI ACE
    PS DI PFT O2 Use
    services
    Size Stage Location Histology PET Paul16
    C C C C C
    C
    C C
    C C Smith17
    C
    C
    C
    C
    C Ezer18
    C
    C
    C C C C C Yu19
    C C C C C
    C
    C Shirvani20
    C
    C
    C
    C C
    C Rosen23
    C
    C C C C
    C C C C C
    C
    C C
    Boyer25
    C
    C
    C
    C
    C
    Crabtree27
    C
    C
    C
    C C C
    Robinson28
    C
    C
    Cornwell33
    C
    C
    C
    Varlotto34
    C
    C
    C
    Kastelijn36
    C
    C r> C C
    Verstegen37
    C
    C
    C
    C C C C
    Palma41
    C
    Miyazaki42
    C
    C
    C
    C
    Hamaji43
    C
    C
    C
    C
    C
    C
    C C
    CCI, Charlson comorbidity index; ACE, adult comorbidity evaluation; PS, performance status; DI, disability index; PFT, pulmonary function tests; PET, pretreatment position emission.
    However, the proportion of patients ligaments underwent SBRT without histopathologic confirmation appeared to differ between European centers and institutions in the United States. Histopathologic demonstration of malignancy was confirmed in more than 90% of surgical patients in all selected studies. In regard to clinical staging, 71% to 84% of matched patients who underwent SBRT had stage IA disease, and 16% to 29% had stage IB disease. For matched patients who underwent surgery, 70% to 82% had stage IA disease, and 18% to 34% had stage IB disease (staged according to the 7th edition of the TNM classification for NSCLC).47
    Overall Survival
    Sixteen studies provided comparative overall survival outcomes on 10,333 patients who underwent SBRT and 142,293 unmatched patients who underwent surgical resection. Fourteen studies reported overall survival for 8946 patients who underwent SBRT and 8942 matched patients who underwent surgery. The unmatched studies demonstrated a significantly superior survival outcome after surgery, compared with SBRT (OR, 2.49; 95% confidence interval [CI], 2.10-2.94; P < .00001; I2 ¼ 86%; Figure 1, A). When the matched cohorts were compared, overall survival remained superior for surgery