Abstract 156P
Background
Recent clinical trials have shown that sub-lobar resection for clinical stage IA non-small cell lung cancer (NSCLC) is non-inferior to lobar resection. However, many criticize the differences between trials in terms of techniques, populations and long-terms outcomes.
Methods
An individual patient data (IPD) meta-analysis was conducted, including patients from the experimental arms of phase III randomized controlled trials (RCTs) comparing sublobar to lobar resection, as well as patients with stage I NSCLC enrolled in the 9th edition of the IASLC database underwent any kind of surgery. IPD was reconstructed from Kaplan-Meier curves of the included studies using the IPDfromKM method. Patients extracted from each trial were compared to the corresponding stage I NSCLC cohort from the IASLC database, stratified by geographic region (Europe, Asia, North America). Survival outcomes were analyzed by comparing the overall survival (OS) curves of the trial cohorts with those of the IASLC database from the same region.
Results
The literature search identified 149 records; 7 reports from 3 studies (CALGB140503 from North America, JCOG0802 from Asia, DRKS00004897 from Europe) were included in the review. Overall, 945 patients were treated with sublobar resections across three trials. A total of 17392 patients from 9th ed of IASLC database were extracted (12798 from Asia, 3307 from North America and 1291 from Europe). Patients from the experimental arm of JCOG0802 had a significantly longer OS compared to the Asian patients included in the IASLC database (HR 0.74 95%CI 0.57–0.97; p=0.028). With regards to CALGB140053, patients treated in the clinical trial had a similar OS compared to the North American patients of the IASLC database (HR 1.1 95%CI 0.89–1.4; p=0.363). Among European patients, the experimental arm of DRKS00004897 had comparable OS to those in the IASLC database (HR 1.2 95%CI 0.65–2.2; p=0.554).
Conclusions
Our analysis demonstrates that the OS of patients treated with sublobar resection within clinical trials is comparable to that of patients treated in real-world settings within corresponding geographic regions.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.