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1% in 2004 to 1.7% in 2016. Factors associated with SBRT were older age, Black race, Medicaid coverage, lower T stage and more recent diagnosis year. Propensity-matching resulted in 1,315 well-balanced pairs. Surgery was associated with higher median survival (74 vs. 47 months, p less then 0.01) in the matched cohort. Survival benefit persisted after adjusting for covariates on Cox regression (HR 1.69, p less then 0.01). CONCLUSIONS Median survival was significantly higher after surgery compared to SBRT in a risk-adjusted matched cohort of patients