• N E Verstegen, J W A Oosterhuis, D A Palma, G Rodrigues, F J Lagerwaard, A van der Elst, R Mollema, W F van Tets, A Warner, J J A Joosten, M I Amir, C J A Haasbeek, E F Smit, B J Slotman, and S Senan.
• Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands. n.verstegen@vumc.nl
• Ann. Oncol. 2013 Jun 1;24(6):1543-8.

BackgroundVideo-assisted thoracoscopic surgery (VATS) lobectomy and stereotactic ablative radiotherapy (SABR) are both used for early-stage non-small-cell lung cancer. We carried out a propensity score-matched analysis to compare locoregional control (LRC).Patients And MethodsVATS lobectomy data from six hospitals were retrospectively accessed; SABR data were obtained from a single institution database. Patients were matched using propensity scores based on cTNM stage, age, gender, Charlson comorbidity score, lung function and performance score. Eighty-six VATS and 527 SABR patients were matched blinded to outcome (1:1 ratio, caliper distance 0.025). Locoregional failure was defined as recurrence in/adjacent to the planning target volume/surgical margins, ipsilateral hilum or mediastinum. Recurrences were either biopsy-confirmed or had to be PET-positive and reviewed by a tumor board.ResultsThe matched cohort consisted of 64 SABR and 64 VATS patients with the median follow-up of 30 and 16 months, respectively. Post-SABR LRC rates were superior at 1 and 3 years (96.8% and 93.3% versus 86.9% and 82.6%, respectively, P = 0.04). Distant recurrences and overall survival (OS) were not significantly different.ConclusionThis retrospective analysis found a superior LRC after SABR compared with VATS lobectomy, but OS did not differ. Our findings support the need to compare both treatments in a randomized, controlled trial.

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