@StephenVLiu@JTOonline Interesting series with very similar results to our previous NCDB study. Only 28% of mortality was after documented acute toxicity, suggesting that patient selection may be an issue. I continue to be surprised that only 34% had biopsy confirmation.
https://t.co/A6Je9fTIVZ
This is an exceptionally good thread for surgeons, radiation oncologists, and oncologists interested in neoadjuvant and perioperative therapy for patients with locally advanced esophageal cancer. #ASCO24
@Chad_Rusthoven @BrendonStilesMD@StokedStokes@DrewMoghanaki@huroqu90@nchudgar A matched analysis of patients who were offered but refused surgery and underwent SBRT (operable by definition) compared to minimally invasive SLR showed superior OS with surgery, I guess that addresses potential confounding factors. Any thoughts on that?
Dr. @LarsSvenssonMD: "How do you stimulate innovation?"
Dr. @drpatrick: "Most of us, of our students, have it in them if they are given the chance. Give people the opportunity."
👏👏👏
#AATS2024
@huroqu90@nchudgar@BrendonStilesMD@EinsteinMed@AATSHQ@AATSJournals The propensity matched comparison only included SBRT patients who were offered surgery but refused, therefore they by definition could have tolerated surgery and have adequate PFTs and performance status.
@LindaMThoracic@huroqu90@nchudgar@BrendonStilesMD@EinsteinMed@AATSHQ@AATSJournals My argument was for surgery, and our study shows superiority of sublobar resection compared to SBRT. We had a heated discussion with radiation oncology colleagues. I wish you get a chance to follow the whole thread. We had a link to the study abstract in the original post.
@huroqu90@nchudgar@BrendonStilesMD@EinsteinMed@AATSHQ@AATSJournals As mentioned in the abstract, in the surgery group almost a quarter of patient were pathologically upstaged to stage 2 or more on final path. I don't think there is any data to support using SBRT for stage 2 disease.
@huroqu90@nchudgar@BrendonStilesMD@EinsteinMed@AATSHQ@AATSJournals Compating SBRT and lobectomy is invalid for many reasons including that sublobar rx is now the standard of care for NSCLC 2 cm or less. The 90d post SBRT mortality was calculated in the same manner like the JCO paper (time of first radiation to time of death/last follow up).
Pleased to share full text link to AATS 2023 Expert Consensus Document: Staging & multidisciplinary management of patients w/ early-stage non-small cell lung cancer.
Incredible team effort led by @biniamkidaneMD@DoctorJSpicer & Matt Bott. @AATSHQ#lcsm
https://t.co/voYwIk12uU