Sublobar resection versus ablation for stage I non-small-cell lung cancer: a meta-analysis

Journal of Cardiothoracic Surgery

Ya-Yong Huang¹  Tao Wang¹  Yong Li²  Fang Yang² 

[1] Department of Radiology, Xuzhou Central Hospital, 199 South Jiefang Road, Xuzhou, China;Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China;

关键词: Sublobar resection;    Ablation;    Lung cancer;    Meta-analysis;   

DOI  :  10.1186/s13019-022-01766-1

来源: Springer

【 摘 要 】

BackgroundStage I non-small-cell lung cancer (NSCLC) can be treated by both ablation and sublobar resection (SR). This meta-analysis was therefore designed to better compare the relative safety and efficacy of these two approaches to treating stage I NSCLC.Materials and methodsRelevant studies published through November 2020 in the Cochrane Library, Embase, and PubMed databases were identified for analyses which were conducted with RevMan v5.3.ResultsIn total, 816 potentially relevant articles were identified, of which 8 were ultimately included in the final meta-analysis. Patients in the SR group exhibited a signficantly lower pooled local recurrence (LR) rate (5.0% vs. 25.4%, P < 0.0001), although pooled distant recurrence (DR) rates were similar in both groups (25.7% vs. 23.1%, P = 0.75). The pooled hazard ratio (HR) for overall survival (OS) (HR: 1.23; 95% CI: 1.13–1.33, P < 0.00001), progression-free survival (PFS) (HR: 1.34; 95% CI: 1.15–1.55, P = 0.0002), and cancer-specific survival (HR: 1.39; 95% CI: 1.15–1.70, P = 0.0009) all indicated better survival outcomes among patients that underwent HR treatment, while pooled complication rates were similar in both groups (27.7% vs. 43.8%, P = 0.27). Patients that underwent ablation exhibited significantly shorter pooled post-operative hospitalization relative to those in the SR group (MD: 5.93; 95% CI: 0.78–11.07, P = 0.02). No evidence of publication bias was detected through funnel plot analyses.ConclusionsSR treatment of stage I NSCLC patients was associated with a lower LR rate and longer survival as compared to ablation.

【 授权许可】

CC BY