• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

I期非小细胞肺癌肺叶切除术与肺段切除术的比较：一项基于随机对照试验的荟萃分析。

Comparison of lobectomy and sublobar resection for stage I non-small cell lung cancer: a meta-analysis based on randomized controlled trials.

作者信息

Lu Genlin, Xiang Zhiyi, Zhou Yan, Dai Senjie, Tong Fei, Jiang Renya, Dai Min, Zhang Qiufeng, Zhang Difeng

机构信息

General Surgery Department, Longyou County People's Hospital, Quzhou, Zhejiang, China.

The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.

出版信息

Front Oncol. 2023 Oct 4;13:1261263. doi: 10.3389/fonc.2023.1261263. eCollection 2023.

DOI:10.3389/fonc.2023.1261263
PMID:37860201
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10582352/
Abstract

BACKGROUND

This meta-analysis aimed to compare the prognostic between lobectomy and sublobar resection in patients with stage I non-small cell lung cancer (NSCLC).

METHODS

We conducted a detailed search in PubMed, Embase, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) comparing the prognosis of lobectomy and sublobar resection for stage I NSCLC, with the primary outcomes being overall survival (OS) and disease-free survival (DFS).

RESULTS

A total of 2222 patients were included in the 5 RCTs. The results showed no statistical difference in OS (HR=0.87, p=0.445) and DFS (HR=0.99, p=0.918) between patients who underwent lobectomy and sublobar resection during the total follow-up period. In terms of dichotomous variables, there were no statistical differences in OS (relative ratio [RR]=1.05, p=0.848) and DFS (RR=1.21, p=0.075) between the two groups during the total follow-up period, as well as 5-year OS (RR=0.96, p=0.409) and 5-year DFS (RR=0.95, p=0.270). In addition, subgroup analysis showed a better prognosis for non-adenocarcinoma patients with sublobar resection than lobectomy (HR=0.53, p=0.037), but also an increased cause of cancer death (not limited to lung cancer) (RR=1.56, p=0.004).

CONCLUSION

Our results showed that for stage I NSCLC, lobectomy is usually not a justified operation.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023407301, identifier CRD42023407301.

摘要

背景

本荟萃分析旨在比较Ⅰ期非小细胞肺癌（NSCLC）患者肺叶切除术和肺段切除术的预后。

方法

我们在PubMed、Embase、Web of Science和Cochrane图书馆中进行了详细检索，以查找比较Ⅰ期NSCLC肺叶切除术和肺段切除术预后的随机对照试验（RCT），主要结局为总生存期（OS）和无病生存期（DFS）。

结果

5项RCT共纳入2222例患者。结果显示，在整个随访期内，接受肺叶切除术和肺段切除术的患者在OS（风险比[HR]=0.87，p=0.445）和DFS（HR=0.99，p=0.918）方面无统计学差异。在二分变量方面，两组在整个随访期内的OS（相对比[RR]=1.05，p=0.848）和DFS（RR=1.21，p=0.075），以及5年OS（RR=0.96，p=0.409）和5年DFS（RR=0.95，p=0.270）方面均无统计学差异。此外，亚组分析显示，肺段切除术的非腺癌患者比肺叶切除术患者预后更好（HR=0.53，p=0.037），但癌症死亡原因（不限于肺癌）也有所增加（RR=1.56，p=0.004）。

结论

我们的结果表明，对于Ⅰ期NSCLC，肺叶切除术通常并非合理的手术方式。

系统评价注册

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023407301，标识符CRD42023407301。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/4ed88d8607a0/fonc-13-1261263-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/ea7510e15fbc/fonc-13-1261263-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/8b660413810e/fonc-13-1261263-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/571f7d95a2eb/fonc-13-1261263-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/5c773923dcca/fonc-13-1261263-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/4ed88d8607a0/fonc-13-1261263-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/ea7510e15fbc/fonc-13-1261263-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/8b660413810e/fonc-13-1261263-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/571f7d95a2eb/fonc-13-1261263-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/5c773923dcca/fonc-13-1261263-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b2/10582352/4ed88d8607a0/fonc-13-1261263-g005.jpg

相似文献

1
Comparison of lobectomy and sublobar resection for stage I non-small cell lung cancer: a meta-analysis based on randomized controlled trials.I期非小细胞肺癌肺叶切除术与肺段切除术的比较：一项基于随机对照试验的荟萃分析。
Front Oncol. 2023 Oct 4;13:1261263. doi: 10.3389/fonc.2023.1261263. eCollection 2023.
2
Sublobar resection versus lobectomy for stage IA non-small-cell lung cancer: A systematic review and meta-analysis of randomized controlled trials.肺段切除术与肺叶切除术治疗IA期非小细胞肺癌的疗效比较：一项随机对照试验的系统评价和荟萃分析
Surg Oncol. 2023 Dec;51:101995. doi: 10.1016/j.suronc.2023.101995. Epub 2023 Sep 22.
3
Sublobar resection versus lobectomy for stage IA non-small-cell lung cancer ≤ 2 cm: a systematic review and patient-level meta-analysis.对于直径≤2 cm的IA期非小细胞肺癌，亚肺叶切除术与肺叶切除术的比较：一项系统评价和患者水平的荟萃分析。
Updates Surg. 2023 Dec;75(8):2343-2354. doi: 10.1007/s13304-023-01627-z. Epub 2023 Aug 10.
4
Less is more in solid-dominant lung cancer? Sublobar resection versus lobectomy for solid-dominant stage IA non-small-cell lung cancer: A meta-analysis study.实性为主型肺癌中少即是多？亚肺叶切除术与肺叶切除术治疗实性为主型IA期非小细胞肺癌的Meta分析研究
Mol Clin Oncol. 2019 Nov;11(5):465-473. doi: 10.3892/mco.2019.1914. Epub 2019 Aug 22.
5
Surgeons' preference sublobar resection for stage I NSCLC less than 3 cm.外科医生更倾向于对小于 3cm 的 I 期非小细胞肺癌行亚肺叶切除术。
Thorac Cancer. 2020 Apr;11(4):907-917. doi: 10.1111/1759-7714.13336. Epub 2020 Feb 9.
6
Sublobar resection versus lobectomy in Surgical Treatment of Elderly Patients with early-stage non-small cell lung cancer (STEPS): study protocol for a randomized controlled trial.老年早期非小细胞肺癌手术治疗中叶下切除与肺叶切除的对比研究（STEPS）：一项随机对照试验的研究方案
Trials. 2016 Apr 7;17:191. doi: 10.1186/s13063-016-1312-6.
7
Meta-analysis of Lobectomy and Sublobar Resection for Stage I Non-small Cell Lung Cancer With Spread Through Air Spaces.I期非小细胞肺癌气腔播散患者肺叶切除术与肺段切除术的Meta分析
Clin Lung Cancer. 2022 May;23(3):208-213. doi: 10.1016/j.cllc.2021.10.004. Epub 2021 Oct 23.
8
Survival rates after lobectomy versus sublobar resection for early-stage right middle lobe non-small cell lung cancer.右中叶早期非小细胞肺癌行肺叶切除术与亚肺叶切除术的生存率。
Thorac Cancer. 2018 Aug;9(8):1026-1031. doi: 10.1111/1759-7714.12782. Epub 2018 Jun 21.
9
Comparison of prognostic impact of lymphovascular invasion in stage IA non-small cell lung cancer after lobectomy versus sublobar resection: A propensity score-matched analysis.肺叶切除与肺段切除术后IA期非小细胞肺癌中淋巴管侵犯的预后影响比较：一项倾向评分匹配分析。
Lung Cancer. 2020 Aug;146:105-111. doi: 10.1016/j.lungcan.2020.04.033. Epub 2020 May 16.
10
Sublobar resection versus lobectomy in patients aged ≤35 years with stage IA non-small cell lung cancer: a SEER database analysis.≤35岁的IA期非小细胞肺癌患者行肺叶下切除与肺叶切除的比较：一项监测、流行病学和最终结果（SEER）数据库分析
J Cancer Res Clin Oncol. 2017 Nov;143(11):2375-2382. doi: 10.1007/s00432-017-2499-y. Epub 2017 Aug 17.

引用本文的文献

1
Reduced expression of E-cadherin correlates with poor prognosis and unfavorable clinicopathological features in gastric carcinoma: a meta-analysis.E-钙黏蛋白表达降低与胃癌预后不良及临床病理特征不良相关：一项荟萃分析。
Aging (Albany NY). 2024 Jun 12;16(12):10271-10298. doi: 10.18632/aging.205929.
2
Survival outcomes following complete mediastinal lymphadenectomy or selective mediastinal lymphadenectomy in patients with stage I-IIIA non-small cell lung cancer: protocol for a systematic review and meta-analysis.Ⅰ期-ⅡIA 期非小细胞肺癌患者行全纵隔淋巴结清扫术或选择性纵隔淋巴结清扫术的生存结局：系统评价和荟萃分析方案。
BMJ Open. 2024 Mar 8;14(3):e084520. doi: 10.1136/bmjopen-2024-084520.

本文引用的文献

1
Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer.肺段或亚肺叶切除术治疗外周型ⅠA 期非小细胞肺癌。
N Engl J Med. 2023 Feb 9;388(6):489-498. doi: 10.1056/NEJMoa2212083.
2
Lobectomy versus sublobar resection for stage I (T1-T2aN0M0) small cell lung cancer: A SEER population-based propensity score matching analysis.肺叶切除术与亚肺叶切除术治疗 I 期（T1-T2aN0M0）小细胞肺癌：一项基于 SEER 人群的倾向评分匹配分析。
Cancer Med. 2023 Apr;12(7):7923-7931. doi: 10.1002/cam4.5568. Epub 2022 Dec 25.
3
Survival outcomes in a prospective randomized multicenter Phase III trial comparing patients undergoing anatomical segmentectomy versus standard lobectomy for non-small cell lung cancer up to 2 cm.
在一项前瞻性随机多中心 III 期临床试验中，比较了 2cm 以下非小细胞肺癌患者行解剖性节段切除术与标准肺叶切除术的生存结果。
Lung Cancer. 2022 Oct;172:108-116. doi: 10.1016/j.lungcan.2022.08.013. Epub 2022 Aug 24.
4
Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial.小型周围型非小细胞肺癌的肺段切除术与肺叶切除术比较（JCOG0802/WJOG4607L）：一项多中心、开放标签、3期、随机、对照、非劣效性试验
Lancet. 2022 Apr 23;399(10335):1607-1617. doi: 10.1016/S0140-6736(21)02333-3.
5
Update of Incidence, Prevalence, Survival, and Initial Treatment in Patients With Non-Small Cell Lung Cancer in the US.美国非小细胞肺癌患者的发病率、患病率、生存率和初始治疗的更新。
JAMA Oncol. 2021 Dec 1;7(12):1824-1832. doi: 10.1001/jamaoncol.2021.4932.
6
Comparison Between Wedge Resection and Lobectomy/Segmentectomy for Early-Stage Non-small Cell Lung Cancer: A Bayesian Meta-analysis and Systematic Review.早期非小细胞肺癌楔形切除术与肺叶切除术/节段切除术的比较：贝叶斯荟萃分析和系统评价。
Ann Surg Oncol. 2022 Mar;29(3):1868-1879. doi: 10.1245/s10434-021-10857-7. Epub 2021 Oct 6.
7
Lobectomy sublobectomy for stage I non-small-cell lung cancer: a meta-analysis.I期非小细胞肺癌的肺叶切除术与肺段切除术：一项荟萃分析。
Ann Transl Med. 2021 May;9(9):751. doi: 10.21037/atm-20-460.
8
Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries.《全球癌症统计数据 2020：全球 185 个国家和地区 36 种癌症的发病率和死亡率估计》。
CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.
9
Prognostic significance of tumor spread through air spaces in patients with stage IA part-solid lung adenocarcinoma after sublobar resection.肺段切除术后 IA 期部分实性肺腺癌患者肿瘤经气腔播散的预后意义
Lung Cancer. 2021 Feb;152:21-26. doi: 10.1016/j.lungcan.2020.12.001. Epub 2020 Dec 5.
10
Significance of tumor spread through air spaces (STAS) in lung cancer from the pathologist perspective.从病理学家角度看肺癌中肿瘤气腔播散（STAS）的意义。
Transl Lung Cancer Res. 2020 Jun;9(3):847-859. doi: 10.21037/tlcr.2020.01.06.