Survival After Lobectomy Versus Sub-lobar Resection in Elderly with Stage I NSCLC: a Meta-analysis

Overview

Journal BMC Surg

Publisher Biomed Central

Specialty General Surgery

Date 2019 Apr 17

PMID 30987622

Citations 6

Authors

Siyuan Dong

Steven A Roberts

Shuang Chen

Xinwen Zhong

Shize Yang

Xiaohan Qu

Shun Xu

Affiliations

Soon will be listed here.

Abstract

Background: We present a critical comparison of lobectomy and sub-lobar resection in elderly patients with early stage non-small cell lung cancer using meta-analytical techniques.

Methods: A literature search was conducted between the period of December 1997 to March 2019 to identify the comparative studies evaluating 1-, 3-, and 5-year survival rates. The pooled odds ratios (OR) and the 95% confidence intervals (95% CI) were calculated with either the fixed or random effect models, respectively.

Results: Six retrospective studies are included in our meta-analysis for a total of 1205 patients. 843 of the individuals were treated with lobectomy, while 362 were treated with sub-lobar resection. We found no significant difference between the lobectomy and the sub-lobar resection in either of the 1-, 3-, or 5-year survival rates.

Conclusions: This study suggests that in elderly individuals with stage I NSCLC, a sub-lobar resection is statistically equivalent to the lobectomy in terms of 1-, 3-, and 5-year survival rates. Further large-scale randomized studies are needed to confirm our results.

Citing Articles

Optimizing the use of adjuvant chemotherapy in non-small cell lung cancer patients with comorbidities.

Bailey S, Wang Q, Kong C, Stone K, Veluswamy R, Bates S Curr Probl Cancer. 2022; 46(4):100867.

PMID: 35687964 PMC: 9276637. DOI: 10.1016/j.currproblcancer.2022.100867.

Treatment Modality for Stage IB Peripheral Non-Small Cell Lung Cancer With Visceral Pleural Invasion and ≤3 cm in Size.

Huang W, Deng H, Lin M, Xu K, Zhang Y, Yuan C Front Oncol. 2022; 12:830470.

PMID: 35280762 PMC: 8905598. DOI: 10.3389/fonc.2022.830470.

The Survival Advantage of Lobectomy over Wedge Resection Lessens as Health-Related Life Expectancy Decreases.

Salazar M, Canavan M, Walters S, Chilakamarry S, Ermer T, Blasberg J JTO Clin Res Rep. 2021; 2(3):100143.

PMID: 34590002 PMC: 8474228. DOI: 10.1016/j.jtocrr.2021.100143.

Comparison of Lobectomy and Sublobar Resection for Stage IA Elderly NSCLC Patients (≥70 Years): A Population-Based Propensity Score Matching's Study.

Zhang B, Liu R, Ren D, Li X, Wang Y, Huo H Front Oncol. 2021; 11:610638.

PMID: 34026604 PMC: 8139614. DOI: 10.3389/fonc.2021.610638.

Comparative Effectiveness of Lobectomy, Segmentectomy, and Wedge Resection for Pathological Stage I Non-small Cell Lung Cancer in Elderly Patients: A Population-Based Study.

Zhang X, Lin G, Li J Front Surg. 2021; 8:652770.

PMID: 33937317 PMC: 8082105. DOI: 10.3389/fsurg.2021.652770.

References

Yancik R, Ries L . Aging and cancer in America. Demographic and epidemiologic perspectives. Hematol Oncol Clin North Am. 2000; 14(1):17-23. DOI: 10.1016/s0889-8588(05)70275-6. View

Edwards B, Howe H, Ries L, Thun M, Rosenberg H, Yancik R . Annual report to the nation on the status of cancer, 1973-1999, featuring implications of age and aging on U.S. cancer burden. Cancer. 2002; 94(10):2766-92. DOI: 10.1002/cncr.10593. View

Brock M, Kim M, Hooker C, Alberg A, Jordan M, Roig C . Pulmonary resection in octogenarians with stage I nonsmall cell lung cancer: a 22-year experience. Ann Thorac Surg. 2004; 77(1):271-7. DOI: 10.1016/s0003-4975(03)01470-x. View

Martin-Ucar A, Nakas A, Pilling J, West K, Waller D . A case-matched study of anatomical segmentectomy versus lobectomy for stage I lung cancer in high-risk patients. Eur J Cardiothorac Surg. 2005; 27(4):675-9. DOI: 10.1016/j.ejcts.2005.01.006. View

Mery C, Pappas A, Bueno R, Colson Y, Linden P, Sugarbaker D . Similar long-term survival of elderly patients with non-small cell lung cancer treated with lobectomy or wedge resection within the surveillance, epidemiology, and end results database. Chest. 2005; 128(1):237-45. DOI: 10.1378/chest.128.1.237. View

Huedo-Medina T, Sanchez-Meca J, Marin-Martinez F, Botella J . Assessing heterogeneity in meta-analysis: Q statistic or I2 index?. Psychol Methods. 2006; 11(2):193-206. DOI: 10.1037/1082-989X.11.2.193. View

El-Sherif A, Gooding W, Santos R, Pettiford B, Ferson P, Fernando H . Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis. Ann Thorac Surg. 2006; 82(2):408-15. DOI: 10.1016/j.athoracsur.2006.02.029. View

Dominguez-Ventura A, Allen M, Cassivi S, Nichols 3rd F, Deschamps C, Pairolero P . Lung cancer in octogenarians: factors affecting morbidity and mortality after pulmonary resection. Ann Thorac Surg. 2006; 82(4):1175-9. DOI: 10.1016/j.athoracsur.2006.04.052. View

Okada M, Koike T, Higashiyama M, Yamato Y, Kodama K, Tsubota N . Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg. 2006; 132(4):769-75. DOI: 10.1016/j.jtcvs.2006.02.063. View

10.

Dominguez-Ventura A, Cassivi S, Allen M, Wigle D, Nichols F, Pairolero P . Lung cancer in octogenarians: factors affecting long-term survival following resection. Eur J Cardiothorac Surg. 2007; 32(2):370-4. DOI: 10.1016/j.ejcts.2007.04.002. View

11.

Colice G, Shafazand S, Griffin J, Keenan R, Bolliger C . Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007; 132(3 Suppl):161S-77S. DOI: 10.1378/chest.07-1359. View

12.

Veronesi G, Bellomi M, Mulshine J, Pelosi G, Scanagatta P, Paganelli G . Lung cancer screening with low-dose computed tomography: a non-invasive diagnostic protocol for baseline lung nodules. Lung Cancer. 2008; 61(3):340-9. DOI: 10.1016/j.lungcan.2008.01.001. View

13.

Rami-Porta R, Tsuboi M . Sublobar resection for lung cancer. Eur Respir J. 2009; 33(2):426-35. DOI: 10.1183/09031936.00099808. View

14.

Smith B, Smith G, Hurria A, Hortobagyi G, Buchholz T . Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol. 2009; 27(17):2758-65. DOI: 10.1200/JCO.2008.20.8983. View

15.

Brunelli A, Charloux A, Bolliger C, Rocco G, Sculier J, Varela G . The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer. Eur J Cardiothorac Surg. 2009; 36(1):181-4. DOI: 10.1016/j.ejcts.2009.04.022. View

16.

Okami J, Higashiyama M, Asamura H, Goya T, Koshiishi Y, Sohara Y . Pulmonary resection in patients aged 80 years or over with clinical stage I non-small cell lung cancer: prognostic factors for overall survival and risk factors for postoperative complications. J Thorac Oncol. 2009; 4(10):1247-53. DOI: 10.1097/JTO.0b013e3181ae285d. View

17.

Pallis A, Gridelli C, Van Meerbeeck J, Greillier L, Wedding U, Lacombe D . EORTC Elderly Task Force and Lung Cancer Group and International Society for Geriatric Oncology (SIOG) experts' opinion for the treatment of non-small-cell lung cancer in an elderly population. Ann Oncol. 2009; 21(4):692-706. DOI: 10.1093/annonc/mdp360. View

18.

Lim E, Baldwin D, Beckles M, Duffy J, Entwisle J, Faivre-Finn C . Guidelines on the radical management of patients with lung cancer. Thorax. 2010; 65 Suppl 3:iii1-27. DOI: 10.1136/thx.2010.145938. View

19.

Okami J, Ito Y, Higashiyama M, Nakayama T, Tokunaga T, Maeda J . Sublobar resection provides an equivalent survival after lobectomy in elderly patients with early lung cancer. Ann Thorac Surg. 2010; 90(5):1651-6. DOI: 10.1016/j.athoracsur.2010.06.090. View

20.

Loo Jr B . Stereotactic ablative radiotherapy (SABR) for lung cancer: What does the future hold?. J Thorac Dis. 2012; 3(3):150-2. PMC: 3256516. DOI: 10.3978/j.issn.2072-1439.2011.06.08. View