Comparison of lobectomy and sublobar resection for stage I non-small cell lung cancer: a meta-analysis based on randomized controlled trials

Frontiers in Oncology

Oncology

Yan Zhou¹  Difeng Zhang²  Fei Tong³  Genlin Lu³  Renya Jiang⁴  Zhiyi Xiang⁵  Qiufeng Zhang⁵  Senjie Dai⁶  Min Dai⁶ 

[1] Anesthesia Surgery Center, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China;Department of Orthopaedics, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang, China;General Surgery Department, Longyou County People’s Hospital, Quzhou, Zhejiang, China;Hepatobiliary Surgery Department, Quzhou City People’s Hospital, Quzhou, Zhejiang, China;The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China;The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China;

关键词: stage I;    non-small cell lung cancer;    lobectomy;    sublobar resection;    meta-analysis;    overall survival;    disease-free survival;   

DOI  :  10.3389/fonc.2023.1261263

 received in 2023-07-19, accepted in 2023-09-18,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThis meta-analysis aimed to compare the prognostic between lobectomy and sublobar resection in patients with stage I non-small cell lung cancer (NSCLC).MethodsWe conducted a detailed search in PubMed, Embase, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) comparing the prognosis of lobectomy and sublobar resection for stage I NSCLC, with the primary outcomes being overall survival (OS) and disease-free survival (DFS).ResultsA total of 2222 patients were included in the 5 RCTs. The results showed no statistical difference in OS (HR=0.87, p=0.445) and DFS (HR=0.99, p=0.918) between patients who underwent lobectomy and sublobar resection during the total follow-up period. In terms of dichotomous variables, there were no statistical differences in OS (relative ratio [RR]=1.05, p=0.848) and DFS (RR=1.21, p=0.075) between the two groups during the total follow-up period, as well as 5-year OS (RR=0.96, p=0.409) and 5-year DFS (RR=0.95, p=0.270). In addition, subgroup analysis showed a better prognosis for non-adenocarcinoma patients with sublobar resection than lobectomy (HR=0.53, p=0.037), but also an increased cause of cancer death (not limited to lung cancer) (RR=1.56, p=0.004).ConclusionOur results showed that for stage I NSCLC, lobectomy is usually not a justified operation.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023407301, identifier CRD42023407301.

【 授权许可】

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Copyright © 2023 Lu, Xiang, Zhou, Dai, Tong, Jiang, Dai, Zhang and Zhang