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Similar NSCLC Survival for Surgical, Endosonographic Staging

Five-year survival not significantly different after mediastinoscopy or endosonographic staging

TUESDAY, Sept. 13, 2016 (HealthDay News) — For patients with non-small-cell lung cancer (NSCLC), there is no survival difference at five years for surgical staging or endosonographic staging, according to a research letter published in the Sept. 13 issue of the Journal of the American Medical Association.

Jolanda C. Kuijvenhoven, M.D., from the Academic Medical Center in Amsterdam, and colleagues conducted a post hoc analysis to examine survival in the Assessment of Surgical Staging vs Endosonographic Ultrasound in Lung Cancer trial, which compared mediastinoscopy (surgical staging) with an endosonographic staging strategy. Of 241 patients with potentially resectable NSCLC, 123 and 118 were randomized to endosonographic and surgical staging, respectively. Survival data were obtained at five years for 237 of the participants.

The researchers found that survival at five years was 35 percent for both the endosonographic and surgical strategies (odds ratio, 0.97; 95 percent confidence interval, 0.57 to 1.66). The estimated median survival was 31 and 33 months, respectively, for the endosonographic and surgical strategies (adjusted hazard ratio, 0.98; 95 percent confidence interval, 0.73 to 1.32). Survival was not significantly different for the endoscopic and surgical staging strategies for the subgroup with N2/N3 metastases or for the subgroup with N0/N1 metastases.

“No survival difference was found five years following randomization to an endosonographic or surgical staging strategy for patients with NSCLC,” the authors write. “The endosonographic strategy is more accurate, less invasive, and reduces unnecessary thoracotomies.”

Two authors disclosed financial ties to the medical device industry.

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