INTRODUCTION: The relative roles of surgery and stereotactic body radiation therapy in stage I @entity1149 ( @entity1149 ) are evolving particularly for marginally operable @entity1 . Because there is limited prospective comparative data for these treatment modalities, we evaluated their relative use and outcomes at the population level using a national database. METHODS: @entity1 variables and treatment-related outcomes were abstracted for @entity1 with clinical stage I @entity1149 from the National @entity5 Database. @entity1 receiving surgery were compared with those undergoing stereotactic body radiation therapy (SBRT) in exploratory unmatched and subsequent propensity matched analyses. RESULTS: Between 1998 and 2010, 117,618 @entity1 underwent surgery or SBRT for clinical stage I @entity1149 . Of these, 111,731 (95%) received surgery, whereas 5887 (5%) underwent SBRT. @entity1 in the surgery group were younger, more likely to be males, and had higher Charlson comorbidity scores. SBRT @entity1 were more likely to have T1 (versus T2) @entity5 and receive treatment at academic centers. Thirty-day surgical mortality was 2596 of 109,485 (2.4%). Median overall survival favored the surgery group in both unmatched (68.4 versus 33.3 months, p < 0.001) and matched analysis based on @entity1 characteristics (62.3 versus 33.1 months, p < 0.001). Disease-specific survival was unavailable from the data set. CONCLUSION: In a propensity matched comparison, @entity1 selected for surgery have improved survival compared with SBRT. In the absence of information on cause of @entity204 and with limited variables to characterize comorbidity, it is not possible to assess the relative contribution of @entity1 selection or better cancer control toward the improved survival. Rigorous prospective studies are needed to optimize @entity1 selection for SBRT in the high-risk surgical population.

Treatment Outcomes in XXXX : A Comparison of Surgery and Stereotactic Body Radiation Therapy.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'Patient'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['NSCLC', 'non-small-cell lung cancer'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Cancer', 'tumors']
@entity5 :: (MESH:D009369,Disease) :: ['Stage I Lung Cancer']
