Sublobectomy Versus Lobectomy for Stage I Non-Small-Cell Lung Cancer, A Meta-Analysis of Published Studies
Annals of Surgical Oncology, 08/01/2011
Evidence Based Medicine
Fan J et al. – For stage I patients, sublobectomy causes lower survival than lobectomy, whereas the outcomes of segmentectomy are comparable to that of lobectomy; for stage Ia patients with tumor <=2 cm, sublobectomy produces similar survival to lobectomy.Methods
- The overall survival/cancer-specific survival (OS/CSS) of stage I NSCLC after sublobectomy or lobectomy was compared.
- The log (hazard ratio) [ln (HR)] and its standard error (SE) were used as the outcome measure for data combining.
- There were 24 eligible studies, published from 1990 to 2010, enrolled (11,360 patients).
- Compared with sublobectomy, there was a significant benefit of lobectomy on OS and CSS of stage I NSCLC patients (HR 1.40; 95% confidence interval [95% CI], 1.15–1.69; P = .0006).
- In stage Ia patients with tumor no large than 2 cm, there were no differences in OS between lobectomy and sublobectomy (HR 0.81; 95% CI, 0.39–1.71; P = .58).
- For the comparison between lobectomy and segmentectomy, there was no significant difference on OS (HR = 1.09; 95% CI, 0.85–1.40; P = .45) and CSS (HR 0.99; 95% CI, 0.72–1.38; P = .97) in stage I NSCLC patients.
- There was no significant publication bias detected in any sections of the analysis.