Hao Xiaohu, Wang Zihuai, Cheng Diou, Zhou Jian, Chen Nan, Pu Qiang, Liu Lunxu
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
West China School of Medicine, Sichuan University, Chengdu, China.
Front Oncol. 2020 Oct 20;10:561935. doi: 10.3389/fonc.2020.561935. eCollection 2020.
Superior sulcus tumor is a rare non-small cell lung cancer with poor prognosis. Exploring the potential prognostic factors of patients with superior sulcus tumor and adopting individualized treatment for patients with different prognostic factors are of great significance for the prolongation of patients' lives. To figure out the prognostic factors of upper sulcus tumors, a meta-analysis was conducted. We searched all the articles published until January 2020 in PubMed, Embase, and Web of Science databases, and the search strategy included the following terms, combining superior sulcus tumor and prognosis. Hazard ratio (HR) with associated confidential interval (CI) was evaluated for the purpose of investigating prognostic factors for superior sulcus tumor. STATA 16.0 was used for analysis of extracted data and assessment of publication bias. Fifteen eligible studies, which had 1,009 patients with superior sulcus tumor, were included in this meta-analysis. The studies were published between 1994 and 2018, and the patient recruitment periods ranged from 1974 to 2016. The median follow-up time ranged from 18 to 95 months. The meta-analysis indicated that lower T stage (HR, 1.63; 95% CI, 1.35-1.97), lower N stage (HR, 3.08; 95% CI: 2.37-3.99), negative surgical margin (HR, 0.25; 95% CI, 0.17-0.38), and pathologic complete response (HR, 0.55; 95% CI, 0.39-0.77) were favorable prognostic factors. We found that T stage, N stage, surgical margin, and pathologic complete response are prognostic factors for superior sulcus tumor. To reach a better long-term survival, patients with these negative prognostic factors may need a more aggressive treatment, while more studies should be conducted to further validate these results and explore a more effective treatment.
肺上沟瘤是一种罕见的非小细胞肺癌,预后较差。探索肺上沟瘤患者的潜在预后因素,并针对不同预后因素的患者采取个体化治疗,对于延长患者生命具有重要意义。为了明确肺上沟瘤的预后因素,进行了一项荟萃分析。我们检索了截至2020年1月在PubMed、Embase和Web of Science数据库中发表的所有文章,检索策略包括以下术语,将肺上沟瘤与预后相结合。为了研究肺上沟瘤的预后因素,评估了危险比(HR)及相关的可信区间(CI)。使用STATA 16.0对提取的数据进行分析并评估发表偏倚。本荟萃分析纳入了15项符合条件的研究,共1009例肺上沟瘤患者。这些研究发表于1994年至2018年之间,患者招募时间范围为1974年至2016年。中位随访时间为18至95个月。荟萃分析表明,较低的T分期(HR,1.63;95%CI,1.35-1.97)、较低的N分期(HR,3.08;95%CI:2.37-3.99)、手术切缘阴性(HR,0.25;95%CI,0.17-0.38)和病理完全缓解(HR,0.55;95%CI,0.39-0.77)是有利的预后因素。我们发现T分期、N分期、手术切缘和病理完全缓解是肺上沟瘤的预后因素。为了获得更好的长期生存,具有这些不良预后因素的患者可能需要更积极的治疗,同时应开展更多研究以进一步验证这些结果并探索更有效的治疗方法。