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Sublobectomy Versus Lobectomy for Stage I Non-Small-Cell Lung Cancer, A Meta-Analysis of Published Studies

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The selection of surgeries for patients with stage I NSCLC remains controversial. We evaluated the effectiveness of different surgeries for stage I NSCLC through a meta-analysis of studies that compared sublobectomy with lobectomy.

Methods

The overall survival/cancer-specific survival (OS/CSS) of stage I NSCLC after sublobectomy or lobectomy was compared. The log (hazard ratio) [ln (HR)] and its standard error (SE) were used as the outcome measure for data combining.

Results

There were 24 eligible studies, published from 1990 to 2010, enrolled (11,360 patients). Compared with sublobectomy, there was a significant benefit of lobectomy on OS and CSS of stage I NSCLC patients (HR 1.40; 95% confidence interval [95% CI], 1.15–1.69; P = .0006). In stage Ia patients with tumor no large than 2 cm, there were no differences in OS between lobectomy and sublobectomy (HR 0.81; 95% CI, 0.39–1.71; P = .58). For the comparison between lobectomy and segmentectomy, there was no significant difference on OS (HR = 1.09; 95% CI, 0.85–1.40; P = .45) and CSS (HR 0.99; 95% CI, 0.72–1.38; P = .97) in stage I NSCLC patients. There was no significant publication bias detected in any sections of the analysis.

Conclusions

For stage I patients, sublobectomy causes lower survival than lobectomy, whereas the outcomes of segmentectomy are comparable to that of lobectomy; for stage Ia patients with tumor ≤2 cm, sublobectomy produces similar survival to lobectomy.

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Acknowledgments

The study was supported in part by a grant from the Ph.D. Programs Foundation of Ministry of Education of China (No. 200802471012). This study also was supported in part by Natural Science Foundation of Shandong Province (2007ZRC03088). Dr. Jiang Fan, Dr. Lei Wang took the responsibility of composing the whole manuscript and finishing the statistical working, and they contributed equally to the work. Dr. Ge-Ning Jiang and Dr. Wen Gao designed the study and interpreted the statistic results. All the authors mentioned here signed the agreement of the distribution they did to the work. Ge-Ning Jiang is identified as the person responsible for editorial correspondence. We also gratefully acknowledge the support from 2 doctors: Dr. Colin Schieman and Dr. Francis C. Nichols from Mayo Clinic.

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Correspondence to Ge-Ning Jiang MD.

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Jiang Fan and Lei Wang contributed to the study equally.

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Fan, J., Wang, L., Jiang, GN. et al. Sublobectomy Versus Lobectomy for Stage I Non-Small-Cell Lung Cancer, A Meta-Analysis of Published Studies. Ann Surg Oncol 19, 661–668 (2012). https://doi.org/10.1245/s10434-011-1931-9

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  • DOI: https://doi.org/10.1245/s10434-011-1931-9

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