Active Surveillance for Early Stage Lung Cancer

Ryan G. Payne, Christopher J. Anker, Brian L. Sprague, Hyunsoo J. No, Steven H. Lin, Nataniel H. Lester-Coll

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)226-235
Number of pages10
JournalClinical Lung Cancer
Volume23
Issue number3
DOIs
StatePublished - May 2022

Keywords

  • Cancer outcomes
  • Expectant Management
  • National Cancer Data Base
  • Non-Small Cell Lung Cancer
  • Stereotactic Body Radiation Therapy

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

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