Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Radiology, Xuzhou Central Hospital, 199 South Jiefang Road, Xuzhou, China.
J Cardiothorac Surg. 2022 Feb 11;17(1):17. doi: 10.1186/s13019-022-01766-1.
Stage I non-small-cell lung cancer (NSCLC) can be treated by both ablation and sublobar resection (SR). This meta-analysis was therefore designed to better compare the relative safety and efficacy of these two approaches to treating stage I NSCLC.
Relevant studies published through November 2020 in the Cochrane Library, Embase, and PubMed databases were identified for analyses which were conducted with RevMan v5.3.
In total, 816 potentially relevant articles were identified, of which 8 were ultimately included in the final meta-analysis. Patients in the SR group exhibited a signficantly lower pooled local recurrence (LR) rate (5.0% vs. 25.4%, P < 0.0001), although pooled distant recurrence (DR) rates were similar in both groups (25.7% vs. 23.1%, P = 0.75). The pooled hazard ratio (HR) for overall survival (OS) (HR: 1.23; 95% CI: 1.13-1.33, P < 0.00001), progression-free survival (PFS) (HR: 1.34; 95% CI: 1.15-1.55, P = 0.0002), and cancer-specific survival (HR: 1.39; 95% CI: 1.15-1.70, P = 0.0009) all indicated better survival outcomes among patients that underwent HR treatment, while pooled complication rates were similar in both groups (27.7% vs. 43.8%, P = 0.27). Patients that underwent ablation exhibited significantly shorter pooled post-operative hospitalization relative to those in the SR group (MD: 5.93; 95% CI: 0.78-11.07, P = 0.02). No evidence of publication bias was detected through funnel plot analyses.
SR treatment of stage I NSCLC patients was associated with a lower LR rate and longer survival as compared to ablation.
Ⅰ期非小细胞肺癌（NSCLC）可通过消融和亚肺叶切除术（SR）进行治疗。因此，本荟萃分析旨在更好地比较这两种治疗Ⅰ期 NSCLC 的方法的相对安全性和疗效。
通过 Cochrane 图书馆、Embase 和 PubMed 数据库检索 2020 年 11 月前发表的相关研究，采用 RevMan v5.3 进行分析。
共识别出 816 篇潜在相关文章，其中 8 篇最终纳入荟萃分析。SR 组患者的局部复发（LR）率明显较低（5.0%比 25.4%，P<0.0001），但两组的远处复发（DR）率相似（25.7%比 23.1%，P=0.75）。总生存（OS）的合并风险比（HR）（HR：1.23；95%CI：1.13-1.33，P<0.00001）、无进展生存（PFS）（HR：1.34；95%CI：1.15-1.55，P=0.0002）和癌症特异性生存（HR：1.39；95%CI：1.15-1.70，P=0.0009）均表明 HR 治疗组患者的生存结果更好，而两组的合并并发症发生率相似（27.7%比 43.8%，P=0.27）。与 SR 组相比，消融组患者术后住院时间明显缩短（MD：5.93；95%CI：0.78-11.07，P=0.02）。漏斗图分析未发现发表偏倚的证据。
与消融相比，SR 治疗Ⅰ期 NSCLC 患者的 LR 率较低，生存时间较长。
