医学
肺癌
阶段(地层学)
荟萃分析
纳入和排除标准
随机对照试验
优势比
外科
癌
癌症
肿瘤科
内科学
病理
古生物学
替代医学
生物
作者
Jia Hui Ng,Yoshio Masuda,Jun Jie Ng,Lowell Leow,Andrew M.T.L. Choong,Harish Mithiran
出处
期刊:Thoracic and Cardiovascular Surgeon
[Georg Thieme Verlag KG]
日期:2021-06-01
卷期号:70 (03): 217-232
标识
DOI:10.1055/s-0041-1726100
摘要
We performed a systematic review and meta-analysis of outcomes of lobectomy versus sublobar resection in elderly patients (≥65) with stage 1 nonsmall cell lung carcinoma (NSCLC).We searched for relevant articles using a set of inclusion and exclusion criteria. Meta-analytic techniques were applied.Twelve studies (n = 5834) were chosen. Our results indicate that in the elderly, lobectomy for stage 1 NSCLC confers a survival advantage over sublobar resection. Lobectomy patients had a lower risk of death within 5 years and lower odds of local cancer recurrence. Our results show that lobectomy had a better 5-year cancer-specific survival and 5-year disease-free survival that trended toward significance. The sublobar resection group showed better 30-day operative mortality that trended toward significance. Subgroup analysis of stage 1A cancer demonstrated no difference in 5-year overall survival rates. However, for stage 1B tumors 5-year overall survival favored lobectomy.Lobectomy for stage 1 NSCLC in elderly patients is superior to sublobar resection in terms of survival and cancer recurrence and should be afforded where possible. For stage 1A tumors, sublobar resection is noninferior and may be considered. Further randomized controlled trials in this topic is required.
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