Limited resection in clinical stage I non-small cell lung cancer patients aged 75 years old or more: a meta-analysis.

BACKGROUND

This study aims to compare perioperative and oncologic efficacy of limited resection with lobectomy in clinical stage I non-small cell lung cancer (NSCLC) patients ≥75 years old.

METHODS

A systemic search of database including PubMed, OVID and Cochrane was carried out to identify the potential relevant studies published. Data extracted were analyzed with Revman 5.1.

RESULTS

5,304 citations were identified by the electronically search. A total of 3,461 patients were included, of whom 1,323 received limited resection and 2,139 received lobectomy. There was higher postoperative complication ratio after lobectomy (32.93% 23.87%, RR =0.71; 95% CI, 0.54-0.93; P=0.01). There were similar total recurrent (18.56%, RR =1.15; 95% CI, 0.82-1.61; P=0.43), and distant recurrent ratio (16.17%, RR =0.67; 95% CI, 0.43-1.05; P=0.08) between groups. Lower local-regional recurrent ratio (2.40%, RR =4.31; 95% CI, 1.98-9.39; P<0.001) was observed after lobectomy. Compared with lobectomy, patients received limited resection showed poorer overall survival (HR =1.24; 95% CI, 1.07-1.44; P=0.004) and lung cancer specific survival (HR =1.37; 95% CI, 1.14-1.64; P<0.001).

CONCLUSIONS

This analysis showed superior lung cancer specific survival, and overall survival after lobectomy over limited resection for clinical stage I NSCLC patients aged ≥75 years old. Our results confirmed that lobectomy should be considered in aged patients if tolerable.