Observational studyBMJ (Clinical research ed.)2016
Long term survival with stereotactic ablative radiotherapy (SABR) versus thoracoscopic sublobar lung resection in elderly people: national population based study with propensity matched comparative analysis.
Observational study in BMJ (Clinical research ed.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 6 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- A systematic review on the effectiveness of robot-assisted minimally invasive gastrectomy.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2024Pooled it
- Stereotactic body radiotherapy versus surgery for early-stage non-small cell lung cancer: an updated meta-analysis involving 29,511 patients included in comparative studies.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2022Pooled it
- Wedge Resection vs. Stereotactic Body Radiation Therapy for Clinical Stage I Non-small Cell Lung Cancer: A Systematic Review and Meta-Analysis.Frontiers in surgery · 2022Pooled it
- [Efficacy of Stereotactic Body Radiotherapy versus Surgery for the Treatment of Early Non-small Cell Lung Cancer: A Meta-analysis].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2020Pooled it
- A systematic review and meta-analysis of stereotactic body radiation therapy versus surgery for patients with non-small cell lung cancer.The Journal of thoracic and cardiovascular surgery · 2019Pooled it
- Pooled it
- A system-based intervention to reduce Black-White disparities in the treatment of early stage lung cancer: A pragmatic trial at five cancer centers.Cancer medicine · 2019Trial
- Comparison among stereotactic body radiation therapy, lobectomy, segmentectomy, and wedge resection for clinical stage I non-small cell lung cancer: a network meta-analysis.Journal of thoracic disease · 2025Article
- Article
- Treatment outcomes in older patients presenting to a radiation oncology clinic based on an electronic health record-based frailty index.Journal of geriatric oncology · 2025Article
- Review
- Survival benefit of surgery vs radiotherapy alone to patients with stage IA lung adenocarcinoma: a propensity score-matched analysis.European journal of medical research · 2025Article
- Article
- Stereotactic body radiation therapy for clinically diagnosed early-stage non-small cell lung cancer: Importance of accurate CT interpretation by experts.Precision radiation oncology · 2024Article
- Management of screening-detected ground glass nodules: a narrative review.Indian journal of thoracic and cardiovascular surgery · 2024Review
- Article
- Sublobar Resection versus Stereotactic Body Radiation Therapy for Clinical Stage I Non-Small Cell Lung Cancer: A Study Using Data from the Korean Nationwide Lung Cancer Registry.Cancer research and treatment · 2023Article
- A guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation-part 4: systematic review of evidence involving SBRT and ablation.Journal of thoracic disease · 2022Review
- The Clinical Outcomes, Prognostic Factors and Nomogram Models for Primary Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy.Frontiers in oncology · 2022Article
- Annual Report to the Nation on the Status of Cancer, Part 1: National Cancer Statistics.Journal of the National Cancer Institute · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesTo compare cancer specific survival after thoracoscopic sublobar lung resection and stereotactic ablative radiotherapy (SABR) for tumors ≤2 cm in size and thoracoscopic resection (sublobar resection or lobectomy) and SABR for tumors ≤5 cm in size.
designNational population based retrospective cohort study with propensity matched comparative analysis.
settingSurveillance, Epidemiology, and End Results (SEER) registry linked with Medicare database in the United States.
participantsPatients aged ≥66 with lung cancer undergoing SABR or thoracoscopic lobectomy or sublobar resection from 1 Oct 2007 to 31 June 2012 and followed up to 31 December 2013.
main outcome measuresCancer specific survival after SABR or thoracoscopic surgery for lung cancer.
results690 (275 (39.9%) SABR and 415 (60.1%) thoracoscopic sublobar lung resection) and 2967 (714 (24.1%) SABR and 2253 (75.9%) thoracoscopic resection) patients were included in primary and secondary analyses. The average age of the entire cohort was 76. Follow-up of the entire cohort ranged from 0 to 6.25 years, with an average of three years. In the primary analysis of patients with tumors sized ≤2 cm, 37 (13.5%) undergoing SABR and 44 (10.6%) undergoing thoracoscopic sublobar resection died from lung cancer, respectively. The cancer specific survival diverged after one year, but in the matched analysis (201 matched patients in each group) there was no significant difference between the groups (SABR v sublobar lung resection mortality: hazard ratio 1.32, 95% confidence interval 0.77 to 2.26; P=0.32). Estimated cancer specific survival at three years after SABR and thoracoscopic sublobar lung resection was 82.6% and 86.4%, respectively. The secondary analysis (643 matched patients in each group) showed that thoracoscopic resection was associated with improved cancer specific survival over SABR in patients with tumors sized ≤5 cm (SABR v resection mortality: hazard ratio 2.10, 1.52 to 2.89; P<0.001). Estimated cancer specific survival at three years was 80.0% and 90.3%, respectively.
conclusionsThis propensity matched analysis suggests that patients undergoing thoracoscopic surgical resection, particularly for larger tumors, might have improved cancer specific survival compared with patients undergoing SABR. Despite strategies used in study design and propensity matching analysis, there are inherent limitations to this observational analysis related to confounding, similar to most studies in healthcare of non-surgical technologies compared with surgery. As the adoption of SABR for the treatment of early stage operable lung cancer would be a paradigm shift in lung cancer care, it warrants further thorough evaluation before widespread adoption in practice.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.