Original Article
Limited resection in clinical stage I non-small cell lung cancer patients aged 75 years old or more: a meta-analysis
Abstract
Background: This study aims to compare perioperative and oncologic efficacy of limited resection with lobectomy in clinical stage I non-small cell lung cancer (NSCLC) patients ≥75 years old.
Methods: A systemic search of database including PubMed, OVID and Cochrane was carried out to identify the potential relevant studies published. Data extracted were analyzed with Revman 5.1.
Results: 5,304 citations were identified by the electronically search. A total of 3,461 patients were included, of whom 1,323 received limited resection and 2,139 received lobectomy. There was higher postoperative complication ratio after lobectomy (32.93% vs. 23.87%, RR =0.71; 95% CI, 0.54–0.93; P=0.01). There were similar total recurrent (18.56%, RR =1.15; 95% CI, 0.82–1.61; P=0.43), and distant recurrent ratio (16.17%, RR =0.67; 95% CI, 0.43–1.05; P=0.08) between groups. Lower local-regional recurrent ratio (2.40%, RR =4.31; 95% CI, 1.98–9.39; P<0.001) was observed after lobectomy. Compared with lobectomy, patients received limited resection showed poorer overall survival (HR =1.24; 95% CI, 1.07–1.44; P=0.004) and lung cancer specific survival (HR =1.37; 95% CI, 1.14–1.64; P<0.001).
Conclusions: This analysis showed superior lung cancer specific survival, and overall survival after lobectomy over limited resection for clinical stage I NSCLC patients aged ≥75 years old. Our results confirmed that lobectomy should be considered in aged patients if tolerable.
Methods: A systemic search of database including PubMed, OVID and Cochrane was carried out to identify the potential relevant studies published. Data extracted were analyzed with Revman 5.1.
Results: 5,304 citations were identified by the electronically search. A total of 3,461 patients were included, of whom 1,323 received limited resection and 2,139 received lobectomy. There was higher postoperative complication ratio after lobectomy (32.93% vs. 23.87%, RR =0.71; 95% CI, 0.54–0.93; P=0.01). There were similar total recurrent (18.56%, RR =1.15; 95% CI, 0.82–1.61; P=0.43), and distant recurrent ratio (16.17%, RR =0.67; 95% CI, 0.43–1.05; P=0.08) between groups. Lower local-regional recurrent ratio (2.40%, RR =4.31; 95% CI, 1.98–9.39; P<0.001) was observed after lobectomy. Compared with lobectomy, patients received limited resection showed poorer overall survival (HR =1.24; 95% CI, 1.07–1.44; P=0.004) and lung cancer specific survival (HR =1.37; 95% CI, 1.14–1.64; P<0.001).
Conclusions: This analysis showed superior lung cancer specific survival, and overall survival after lobectomy over limited resection for clinical stage I NSCLC patients aged ≥75 years old. Our results confirmed that lobectomy should be considered in aged patients if tolerable.
