Surgery Versus Optimal Medical Management Of Early-Stage Small Cell Lung Cancer.

8511Background: Differences in the use and impact of surgery versus optimal medical management (concurrent chemoradiation) for patients with cT1-2N0M0 SCLC have never been evaluated in population-based studies. Using the National Cancer Data Base (NCDB), we tested the hypothesis that surgery is rarely used but offers a survival advantage over concurrent chemoradiation for patients with cT1-2N0M0 SCLC. Methods: Overall survival (OS) of patients with cT1-2N0M0 SCLC who underwent concurrent chemoradiation versus surgery with adjuvant chemotherapy ± radiation in the NCDB from 2003 to 2011 was assessed using propensity-score-matched analysis. Groups were matched for common prognostic covariates (age, sex, race, year of diagnosis, insurance type, median household income, education, treatment facility type, distance from facility, hospital volume, clinical T status, and Charlson/Deyo comorbidity condition score). Results: Of 4,729 patients who were treated for cT1-2N0M0 SCLC during the study period, 681 (14.4%) ...