Surgical Outcomes for Early-Stage Non-Small Cell Lung Cancer at Facilities with Stereotactic Body Radiation Therapy Programs.

ABSTRACT Background Patients undergoing surgery for early-stage non-small cell lung cancer (NSCLC) may be at high risk for post-operative mortality. Access to stereotactic body radiation therapy (SBRT) may facilitate more appropriate patient selection for surgery. Research Question Is post-operative mortality for early-stage NSCLC lower at facilities with higher utilization of SBRT? Study Design and Methods Patients with early-stage NSCLC reported to the National Cancer Database between 2004-2015 were included. Utilization of SBRT was defined by each facility’s SBRT Experience (years) and SBRT-to-Surgery Volume Ratios. Multivariable logistic regression was used to test for the associations between SBRT utilization and post-operative mortality. Results The study cohort consisted of 202,542 patients who underwent surgical resection of cT1-T2N0M0 NSCLC. The 90-day post-operative mortality rate declined during the study period from 4.6% to 2.6% (p Interpretation Patients who underwent resection for early-stage NSCLC at facilities with higher SBRT utilization had lower rates of post-operative mortality. These findings suggest that the availability and utilization of SBRT may improve the selection of patients for surgery who are predicted to be at a high-risk for post-operative mortality.