Study on Benefits of Surgery for Lung Cancer

Murray, UT (8/7/2009) – Physicians for years have debated the best way to treat patients with a specific form of lung cancer. A radiation oncologist at Intermountain Medical Center and colleagues from around the globe this week released a study that shows that surgery can be beneficial for some patients. Results of the study will help physicians and surgeons find the best course of treatment for patients with stage III lung disease.

The role of surgery in lung cancer patients whose disease has spread to lymph nodes has been an area of medical controversy for many years. Surgery increases disease control in the chest, but surgical complications have raised questions about whether this approach actually improves survival rates for patients.

“We wanted to use a randomized trial to find out if the benefits of surgery outweigh the risk of complications for select patients with node-positive lung cancer,” said William Sause, MD, chief of the cancer program at Intermountain Medical Center, who headed up the National Institutes of Health research group that launched the study in 1993. “Our results have helped to clarify the best treatment options for patients with this particular form of cancer.”

Non-small-cell lung cancer makes up about 80 percent of all lung cancers, and is the deadliest cancer in the United States. It is most commonly caused by exposure to tobacco smoke. An estimated 219,000 Americans will develop lung cancer this year, and 163,000 will die from it, according to the American Cancer Society.

The study published in the prestigious medical journal, The Lancet, looked at patients whose lung cancer had spread to the lymph nodes in the chest, but not beyond. Study participants were divided into two groups. Both were treated with radiation and chemotherapy, and then one group had surgery to remove portions of the lung.

Researchers found that on average, patients from both groups lived approximately the same length of time after treatment. But more patients who were assigned to the surgery group survived to the five-year mark (37 out of 202, compared to 24 of the 194 who did not have surgery). Those who had surgery also seemed to survive longer without the cancer progressing, 12.8 months versus 10.5 months. The number of patients without disease progression at five years was 32 for the surgery group, versus 13 for the non-surgical patients.

The study also found that for these patients, lobectomy — surgical removal of a lobe of the lung — was preferable to a pneumonectomy, or removal of the entire lung.

“Surgery can be a very valuable tool. But our study shows that it needs to be used very selectively,” said Dr. Sause.

Dr. Sause was among 17 researchers from throughout the world to participate in the study.