Survival Following Sublobar Resection Versus Lobectomy in Patients with Early-stage Non-small Cell Lung Cancer in Asia: A Meta-analysis
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Zhe Sun, Jiaqi Li, Xiaolu Fang, Hong Yu
Background: Lobectomy is still the preferred treatment for patients with stage I NSCLC, but there is renewed interested in performing sublobar resection for ‘intentional’ selected patients with early-stage NSCLC (tumor size ≦ 2 cm). The objective of this study was comparing lobectomy and sublobectomy treatment to the early clinical stage NSCLC (tumor size ≦ 2 cm), ‘intentional’ selected program in the cohort of patients, in Asia. Methods: The searching strategy was developed in EMBASE, MEDLINE and Cochrane library from their earliest publication dates to May 2018. Our main endpoint was 5-year overall survival, used a fixed-effects model to evaluate aggregated data. Results: Of the 2,348 research literatures, 8 were eligible for inclusion and included in the analysis (N = 17817 participants). Compared with sublobar resection, lobectomy has no significant benefit for 5-year OS in patients with stage IA NSCLC with a tumor diameter of less than 2 cm HR, 0.88 (95% CI, 0.68 -1.13; P = 0.31). The combined OR for local recurrence was 0.87 (95% CI, 0.49 - 1.56; P = 0.65). Conclution: There was no significant difference in 5-year OS and local recurrence in early Asian NSCLC patients who were ‘intentional’ selected for sublobar resection compared with patients undergoing lobectomy. These results should be further confirmed through prospective randomized trials.
No-small lung cancer, sublobar resection, lobectomy, 5-year overall survival, Asia, meta-analysis