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Poor Baseline QOL Failed to Predict Worse Outcomes in NSCLC

Poor Baseline QOL Failed to Predict Worse Outcomes in NSCLC | Lung Cancer Dispatch | Scoop.it

"Poor baseline quality-of-life scores did not predict worse survival outcomes among patients undergoing non–small cell lung cancer surgery who were at high risk for adverse events.


"In a randomized, multicenter trial, Hiran C. Fernando, MD, chief of the division of thoracic surgery at Boston Medical Center, evaluated 212 patients with NSCLC who were randomly assigned to undergo sublobar resection or sublobar resection with brachytherapy."


Editor's note: This story describes a study that tracked the quality of life of volunteers with non-small cell lung cancer (NSCLC) who were undergoing surgery to remove their tumors and who were at high risk for harmful side effects of the surgery. The study aimed to determine if low quality of life before surgery was linked with worse outcomes of the surgery. Contrary to previous studies, this study found that poor quality of life did not predict poor surgical outcomes.

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Healio  |  Jun 24, 2014

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Postop Opioid Use Tied to NSCLC Recurrence

Postop Opioid Use Tied to NSCLC Recurrence | Lung Cancer Dispatch | Scoop.it

"Non-small cell lung cancer (NSCLC) patients who experienced disease recurrence half a decade after surgery received a significantly higher dose of opioids postoperatively, researchers said here.


"In a retrospective study among patients treated for early-stage NSCLC, recurrence occurred in 26 who received a mean dose of 232 mg of opioids in the 96 hours after surgery compared with 124 mg of opioids administered to the 73 patients in whom there was no recurrence in 5 years (P=0.020), reported Dermot Maher, MD,from Cedars-Sinai Medical Center in Los Angeles, and colleagues."

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MedPage Today  |  May 4, 2014

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CT in Operating Room Allows More Precise Removal of Small Lung Cancers

CT in Operating Room Allows More Precise Removal of Small Lung Cancers | Lung Cancer Dispatch | Scoop.it

"A new technique that brings CT imaging into the operating room will allow surgeons to precisely demarcate and remove small sub-centimeter lung nodules, leaving as much healthy tissue as possible, according to a researcher. Lung cancer remains the deadliest cancer and a recent study indicated that screening with low-dose computed tomography (CT) scans in smokers, who have certain risk factors, may decrease the number of deaths. Lung cancer screening with CT can detect many small lung lesions that can potentially be cancerous and should be removed surgically."

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ScienceDaily  |  Apr 30, 2014

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Management of Elderly Patients with Lung Cancer

"An expert opinion on managing treatment for elderly patients with non-small cell lung cancer has been recently published. This update includes recommendations for screening, surgery, adjuvant chemotherapy and radiotherapy, treatment of locally advanced and metastatic disease as well as new data on patient preferences and geriatric assessment."

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ScienceDaily  |  Apr 22, 2014

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Preop PET Cuts Lung Cancer Surgery

Preop PET Cuts Lung Cancer Surgery | Lung Cancer Dispatch | Scoop.it

"Routine preoperative PET imaging led to a significant reduction in unnecessary surgery for non-small cell lung cancer (NSCLC), a review of almost 1,000 cases showed.


"Overall, the rate of unnecessary operations, defined as discovery of metastatic disease during surgery, decreased by 13%, which did not achieve statistical significance, according to Steven Zeliadt, PhD, of the Veterans Affairs Medical Center in Seattle, and co-authors. After adjustment for confounding factors, however, unnecessary operations occurred almost 50% less often with preoperative PET imaging."

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MedPage Today  |  Mar 7, 2014

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Radiation Before Surgery May Increase Survival in Mesothelioma Patients

Radiation Before Surgery May Increase Survival in Mesothelioma Patients | Lung Cancer Dispatch | Scoop.it

A study in 25 patients with mesothelioma, a type of lung cancer associated with exposure to asbestos, suggests that radiation treatment before surgery can significantly increase survival. Patients were treated using a new approach dubbed SMART (Surgery for Mesothelioma After Radiation Therapy). They received an accelerated, 5-day course of intensity-modulated radiation therapy (IMRT), which conforms the radiation dose around the tumors while sparing nearby healthy tissues. They then underwent surgery to remove the affected lung. Seventy-two percent of patients survived 3 years or more after treatment; 3-year survival rates without SMART rank at 32%. People with known exposure to asbestos who experience shortness of breath, weight loss, and fatigue for more than 3 weeks should be evaluated by a doctor to ensure speedy access to treatment.

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ScienceDaily  |  Jan 20, 2014

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Advances in Screening and Surgery Improve Lung Cancer Survival

Advances in Screening and Surgery Improve Lung Cancer Survival | Lung Cancer Dispatch | Scoop.it

New U.S. guidelines recommending low-dose computed tomography (CT) scans to screen for lung cancer in high-risk individuals are leading to earlier detection and better survival for lung cancer patients. Screening is available without a prescription for people who have smoked the equivalent of at least a pack of cigarettes per day for 30 years. The scans can uncover lung cancer in early stages, when the chances for successful treatment are the highest. Recent medical advances have also made lung cancer surgery less invasive. Robotic surgeries can often be performed through small incisions in the chest, without the need to crack open ribs. These developments mean more lung cancer patients can undergo surgery and those who do have an easier recovery.

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Tampa Bay Times  |  Nov 29, 2013

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Giving Lung Cancer Surgeons a 3-D View

Giving Lung Cancer Surgeons a 3-D View | Lung Cancer Dispatch | Scoop.it

Minimally invasive surgery (MIS) is performed using surgical tools on long, thin 'stalks' that are inserted through small incisions (less than 1 inch). A small video camera on a flexible tube is introduced through another small hole to guide the surgeon's work. MIS offers less pain and faster recovery than traditional surgery. However, previously, the camera had only been able to transmit two-dimensional images to the surgeon, who had to perform the surgery without proper depth perception. Now, three-dimensional (3-D) video-assisted thoracoscopic surgery (VATS) adds a new dimension. Surgeons wear 3-D goggles during the surgery, giving them a clearer picture of the region on which they are operating. VATS can be used for various chest surgeries, including lung cancer surgeries.

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ScienceDaily | Oct 28, 2013

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Trial Investigating Iressa After Lung Cancer Surgery Terminated Early

A clinical trial investigating whether the cancer drug gefinitib (Iressa) can improve outcomes after lung cancer surgery has been ended early. The trial followed patients who were given either Iressa or a placebo after receiving surgery to completely remove their non-small cell lung cancer (NSCLC). When two other studies showed no benefit of Iressa in similar disease situations, the trial was terminated. Due to the early termination of the trial, no firm conclusions can be drawn from the results. However, analysis of the already collected data suggests that Iressa likely did not improve survival, or delay cancer recurrence in this patient population, and may have indeed been harmful.

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CancerNetwork | Sep 2, 2013

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Gene Variations May Help Predict Response to Lung Cancer Treatment

Gene Variations May Help Predict Response to Lung Cancer Treatment | Lung Cancer Dispatch | Scoop.it

Researchers have discovered genetic variations that may predict risk of death and help direct treatment for lung cancer patients. The researchers analyzed the DNA of patients with non-small cell lung cancer (NSCLC), looking for variations associated with survival. Four of the variants they identified were located on the same gene, called TNFRSF10B. Patients with these genetic variants had up to a 41% higher chance of death, especially if they were treated with surgery only. In contrast, if these patients received chemotherapy after surgery, their risk of death was not increased. The genetic variants may therefore be useful biomarkers for guiding treatment decisions.

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Medical Xpress | Aug 9, 2013

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'iKnife' Could Revolutionize Cancer Surgery

'iKnife' Could Revolutionize Cancer Surgery | Lung Cancer Dispatch | Scoop.it

A new surgical tool–dubbed the 'iKnife'–has the potential to change the way surgeons operate on cancer patients. Typically, surgeons use knives that vaporize tumors during procedures, which produces a strong-smelling smoke. Under standard protocol the surgeon must send tissue to the lab to be analyzed to determine whether or not it is cancerous, waiting on the results while the patient lies on the operating table for close to 30 minutes. The 'iKnife' eliminates the lab work, analyzing the smoke on its own to distinguish cancerous tissue from healthy tissue; it can tell doctors if the tissue is cancerous almost instantaneously. In a recent study, the knife correctly detected cancer in all 91 patients. Researchers believe the knife will lower tumor recurrence rates and enable more accurate procedures.

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CBS News | Jul 17, 2013

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CBS News | Jul 17, 2013

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CBS News | Jul 17, 2013

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CBS News | Jul 17, 2013

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Radiation and Chemotherapy Before Surgery Best Option in Patients with Stage IIIA(N2) NSCLC

Disagreement persists about the best treatment for non-small cell lung cancer (NSCLC) patients with stage IIIA(N2) disease, that is, cancer that has spread to lymph nodes just outside the lung. A recent study compared the outcomes of different treatments. Patients who had received neoadjuvant chemoradiotherapy (chemotherapy and radiation administered before surgery) followed by lobectomy (removal of the lung subsection containing the cancer) had higher 5-year survival rates than patients treated with:

  • neoadjuvant chemoradiotherapy and pneumonectomy (removal of the whole lung containing the cancer);
  • either lobectomy or pneumonectomy plus adjuvant therapy (chemotherapy and/or radiation administered after surgery);
  • concurrent chemoradiotherapy (chemotherapy and radiation delivered at the same time, without surgery).

These findings suggest that neoadjuvant chemoradiotherapy followed by lobectomy is the preferable treatment for stage IIIA(N2) NSCLC.

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Journal of Thoracic Oncology | Jul 1, 2013

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Low-Radiation CT Scan Superior for Detecting Lung Cancer Recurrences

Low-Radiation CT Scan Superior for Detecting Lung Cancer Recurrences | Lung Cancer Dispatch | Scoop.it

A new screening method may offer a better way to monitor recurrence after lung cancer surgery. Recurrence is common, but traditional screening methods, including chest x-rays and computed tomography (CT) scans, have significant drawbacks. A new minimal dose CT (MnDCT) scan reduces radiation exposure to no more than that of standard x-rays, but it maintains superior sensitivity. In a recent study, MnDCT detected 94% of cancer recurrences in patients who had received surgery to remove stage I or II lung cancer; x-rays caught only 21%. However, MnDCT has a high rate of false positives (ie, detecting lung cancer when none is actually present), which is of concern because recurrence may call for invasive and potentially dangerous follow-up procedures.

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Medical Xpress | May 6, 2013

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Survey Sheds Light on Common Clinical Practice for Incompletely Resected Lung Cancer

"A landmark survey of more than 700 specialists provides crucial real-world insight into the treatments most oncologists choose for lung cancer patients whose tumour has been incompletely resected, an expert from the European Society for Medical Oncology (ESMO) says.

"Jean Yves Douillard, from the ICO Institut de Cancerologie de l'Ouest René Gauducheau, France, Chair of the ESMO Educational Committee, was commenting on a paper published in the journal Lung Cancer. In the study, researchers led by Raffaele Califano of The Christie NHS Foundation Trust, Manchester, UK, surveyed 768 oncologists from 41 European countries about the treatments they offered patients who had 'R1 resected' non-small-cell lung cancer."

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Medical Xpress  |  Jun 10, 2014

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Major Lung Resection Safer than Ever, Especially at the Busiest Hospitals

Major Lung Resection Safer than Ever, Especially at the Busiest Hospitals | Lung Cancer Dispatch | Scoop.it

"Major lung surgery has become progressively safer over the last few decades, although higher death rates at low-volume hospitals and an unexpected increase in mortality at 90 days compared to 30 days were observed. The study further suggests that choosing a center that performs major lung surgery regularly can have a strong impact on survival."

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ScienceDaily  |  Apr 29, 2014

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Poor Quality of Life Does Not Predict Low Survival Rates in High-Risk Lung Cancer Patients Undergoing Surgery

Poor Quality of Life Does Not Predict Low Survival Rates in High-Risk Lung Cancer Patients Undergoing Surgery | Lung Cancer Dispatch | Scoop.it

"Quality of life is rarely reported in surgical publications, yet it can be an important metric that can be of use to physicians and patients when making treatment decisions. Prior studies of average-risk patients undergoing lobectomy suggested that low baseline quality-of-life scores predict worse survival in patients undergoing non–small cell lung cancer surgery.


"However, the results of a multicenter, longitudinal study of high-risk lung cancer patients who underwent sublobar resection counters this idea, finding that poor baseline global quality-of-life scores did not predict for worse overall survival or recurrence-free survival or greater risk of adverse events. Bryan F. Meyers, MD, presented the results of this research today on behalf of the Alliance for Clinical Trials in Oncology at the 94th American Association for Thoracic Surgery Annual Meeting in Toronto, Ontario."

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The ASCO Post  |  Apr 29, 2014

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Phase II Trial Shows Feasibility of Customized Adjuvant Treatment in NSCLC, but Phase III Trial Canceled Due to Unreliability of ERCC1 Readouts

Phase II Trial Shows Feasibility of Customized Adjuvant Treatment in NSCLC, but Phase III Trial Canceled Due to Unreliability of ERCC1 Readouts | Lung Cancer Dispatch | Scoop.it

"In the phase II Tailored Postsurgical Therapy in Early-Stage NSCLC (TASTE) trial (IFCT-0801), reported in the Journal of Clinical Oncology, Wislez et al examined the feasibility of customized adjuvant treatment based on EGFR mutation status and expression of ERCC1 (excision repair cross-complementation group 1), a predictor of cisplatin response, in patients with non–small cell lung cancer (NSCLC). Although the trial met its primary endpoint of ≥ 80% of patients being able to start adjuvant chemotherapy within 2 months of surgery, a phase III trial of the customized approach was cancelled due to unreliability of ERCC1 immunohistochemical readouts."


Editor's note: This trial tested whether a particular molecular testing method could be used to decide which lung cancer patients might benefit from chemotherapy after surgery to keep the cancer from returning. While the results of the trial were promising, the third phase of the trial was canceled because of some unreliability of the molecular testing method. Another method called Pervenio, already performs a similar function.

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The ASCO Post  |  Mar 31, 2014

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Analysis Finds No Survival Advantage from Mesothelioma Surgery, According to Surviving Mesothelioma

"A new article in the Journal of Thoracic Surgery says a certain subset of mesothelioma patients is unlikely to see much of a survival benefit from surgery. As Surviving Mesothelioma reports, researchers from six different Italian institutions analyzed survival data on 1,365 consecutive mesothelioma patients treated between 1982 and 2012."

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PRWeb  |  Feb 25, 2014

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Gene Expression Pattern Predicts Risk in Early Lung Cancer

Gene Expression Pattern Predicts Risk in Early Lung Cancer | Lung Cancer Dispatch | Scoop.it

In a past clinical trial, researchers identified a collection of 15 genes whose expression pattern predicted the relative risk of death in people with early-stage non-small cell lung cancer (NSCLC). Now, a new study has confirmed these findings in a larger, independent group of patients. Early-stage NSCLC patients who were classified into high- or low-risk groups based on testing the expression of the 15 genes differed significantly in their overall 5-year survival. These gene expression patterns may therefore help distinguish patients at higher risk who would benefit from adjuvant chemotherapy (chemotherapy given after tumor removal surgery), from lower-risk patients who could avoid the side effects of chemotherapy. Indeed, the Pervenio test, which looks at the expression of 14 genes, is already used to identify the patient who may benefit from aduvant chemotherapy.

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Medical News Today  |  Dec 9, 2013

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Survival Rates after Lung Cancer Surgery Essentially Unchanged Since 1950s

Survival Rates after Lung Cancer Surgery Essentially Unchanged Since 1950s | Lung Cancer Dispatch | Scoop.it

Despite advances in cancer research, the survival rates of lung cancer patients after surgery have not changed significantly in the last 60 years, highlighting the need for better therapies. After specialist chest surgery, patients have a 5-year survival rate of 25% and a 10-year survival rate of 15%; survival rates are lower in patients whose cancer is inoperable or who are too weak to receive surgery. However, lung cancer patients are now much more likely to be treated by a chest specialist surgeon than they were in the 1950s. Nevertheless, referral rates to chest specialist units for lung cancer patients can and should still be improved. These concerns, along with other challenges facing lung cancer research, are discussed in a new book on the history of lung cancer.

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Medical Xpress  |  Nov 20, 2013

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Previously Neglected Lymph Nodes Are Significant in Mesothelioma

To assess cancer stage, that is, how far advanced a cancer is, doctors routinely examine lymph nodes. However, a subset of lymph nodes located between the ribs near the spine, the so-called posterior intercostal lymph nodes, are not usually assessed in cancer staging. In a retrospective study of patients who had undergone surgery for mesothelioma (a type of lung cancer associated with asbestos exposure), researchers found that the cancer had spread to the posterior intercostal lymph nodes in over half of these patients. Patients who had no evidence of cancer in the posterior intercostal lymph nodes lived nearly 2.5 years longer, on average, than those who had. The posterior intercostal lymph nodes appear to be highly significant and should be biopsied routinely in mesothelioma patients.

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Penn Medicine | Oct 28, 2013

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Selenium Does Not Prevent Lung Cancer Recurrence

Selenium has been suggested to have preventative effects against lung cancer. In a recent clinical trial, patients with stage I non-small cell lung cancer (NSCLC) that had been completely surgically removed were given either selenium supplements or a placebo for 2 years after surgery. Interim results showed that patients receiving selenium were no less likely to have their lung cancer return than those given a placebo. Because there were hints that selenium-treated patients may be indeed more likely to develop new tumors, the study was halted. Final analyses show no harm from taking selenium, but no protection against lung cancer either.

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Journal of Clinical Oncology | Sep 3, 2013

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Tissue Analysis May Help Predict Risk of Early-Stage Lung Cancer Returning

Tissue Analysis May Help Predict Risk of Early-Stage Lung Cancer Returning | Lung Cancer Dispatch | Scoop.it

The tissue types present in early-stage lung adenocarcinomas, a type of non-small cell lung cancer (NSCLC), may help predict the chances of the cancer returning after surgery. A retrospective study examined outcomes among adenocarcinoma patients whose tumors were 2 cm in diameter or smaller. Patients whose tumors contained 5% or more of a so-called 'micropapillary' tissue structure had a higher risk of the cancer returning if they had just the tumor removed. This difference was not found in patients who underwent lobectomy (removal of an entire subsection of lung). The higher risk of recurrence in patients with 5%-plus micropapillary tissue in their tumor may make them better candidates for the more invasive lobectomy procedure.

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MedPage Today | Aug 7, 2013

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New Tool Helps Remove Tumors Completely

New Tool Helps Remove  Tumors  Completely | Lung Cancer Dispatch | Scoop.it

Lumpectomies can save breasts but surgeons often have difficulty finding the tumor edges—and this means women often need follow-up surgeries to get the rest of the breast cancer. Now, a new device helps tell surgeons right away if they got all of the tumor. Called MarginProbe, the device uses radio waves to detect tumor edges in tissue that has been removed. In a trial of 600 lumpectomies, women were more likely to avoid second surgeries with the device than without it (69% vs 58%). Ultimately, the device may be customized to work on other types of cancers.

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The Wall Street Journal│Jul 8, 2013

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The Wall Street Journal│Jul 8, 2013

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The Wall Street Journal│Jul 8, 2013

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Analysis Highlights Most Cost-Effective Treatments for Early-Stage Lung Cancer

Researchers have constructed a model to assess the cost-effectiveness of different treatments for stage I non-small cell lung cancer (NSCLC) based on treatment costs, predicted life expectancy, and expected quality of life. Model simulations indicate that lobectomy (removal of an entire subsection of the lungs) is the most cost-effective treatment for patients whose cancer is clearly operable. For patients who are only borderline eligible for surgery due to poor health ('marginally operable'), who often cannot withstand lobectomy, a type of radiotherapy called stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), was found to be more cost-effective than wedge resection (removal of a small piece of lung containing the cancer).

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CancerNetwork | June 26, 2013

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