ArticleAnnals of surgery2026
Real-world Decision-making Process for Stereotactic Body Radiotherapy Versus Minimally Invasive Surgery in Early-stage Lung Cancer Patients.
Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Long-term outcomes of additional surgical versus nonsurgical treatment after non-curative endoscopic resection for T1 superficial esophageal cancer.International journal of surgery (London, England) · 2026Pooled it
- Synchronous Primary Early-Stage Non-Small Cell Lung Cancer: Trends in Management and Factors Associated With Improved Survival.The Annals of thoracic surgery · 2025Article
- Real-World Outcomes of Limited Resection for Tumours Greater Than 20 mm in Non-Small Cell Lung Cancer.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Article
- Comparison and validation of the Japanese classification 12th edition and American joint committee on cancer 8th edition on intrathoracic esophageal squamous cell carcinoma.Esophagus : official journal of the Japan Esophageal Society · 2025Article
- Stereotactic body radiation therapy for early-stage non-small cell lung cancer: a single-institutional retrospective analysis of outcomes and prognostic factors.Frontiers in oncology · 2025Article
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19 authors.
Funding
Abstract
objectiveTo generate a prediction model for the selection of treatment modality for early-stage non-small cell lung cancer (NSCLC).
backgroundStereotactic body radiotherapy (SBRT) and minimally invasive surgery (MIS) are used in the local treatment of early-stage NSCLC. However, the selection of patients for either SBRT or MIS remains challenging due to the multitude of factors influencing the decision-making process.
methodsWe analyzed 1291 patients with clinical stage I NSCLC treated with intended MIS or SBRT from January 2020 to July 2023. A prediction model for selection for SBRT was created based on multivariable logistic regression analysis. The receiver operating characteristic curve analysis stratified the cohort into 3 treatment-related risk categories. Postprocedural outcomes, recurrence, and overall survival (OS) were investigated to assess the model's performance.
resultsIn total, 1116 patients underwent MIS and 175 SBRT. The prediction model included age, performance status, previous pulmonary resection, MSK-Frailty score, FEV1 and DLCO, and demonstrated an area-under-the-curve of 0.908 (95% CI: 0.876-0.938). Based on the probability scores (n=1197), patients were stratified into a low-risk (MIS, n=970 and SBRT, n=28), intermediate-risk (MIS, n=96 and SBRT, n=53), and high-risk category (MIS, n=10 and SBRT, n=40). Treatment modality was not associated with OS [HR of SBRT, 1.67 (95% CI: 0.80-3.48); P =0.20].
conclusionsClinical expertise can be translated into a robust predictive model, guiding the selection of stage I NSCLC patients for MIS versus SBRT and effectively categorizing them into 3 distinct risk groups. Patients in the intermediate category could benefit most from multidisciplinary evaluation.
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