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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

  • Authors:
    • Juntang Guo
    • Yang Liu
    • Xiaodong Tian
    • Zhipeng Ren
    • Jixing Lin
    • Bailin Wang
    • Chaoyang Liang

  • View Affiliations

  • Published online on: August 22, 2019     https://doi.org/10.3892/mco.2019.1914
  • Pages: 465-473

  • Copyright: © Guo et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Although lobectomy is well established as the standard surgical procedure for stage IA non‑small‑cell lung cancer (NSCLC), sublobar resection is increasingly preferred, particularly in intentional segmentectomy for radiologically less‑invasive small NSCLC. However, the indication for sublobar resection of radiologically pure solid or solid‑dominant NSCLC remains controversial, owing to its invasive pathological characteristics. Therefore, the present meta‑analysis was conducted to compare the efficacy of sublobar resection with lobectomy for treating solid‑dominant stage IA NSCLC. An electronic search was conducted using four online databases from their dates of inception to April 2017. The hazard ratio (HR) was used as a summary statistic for censored outcomes and the odds ratio (OR) was used as the summary statistic for dichotomous variables. A total of nine studies met the selection criteria, including a total of 2,265 patients (1,728 patients underwent lobectomy, 425 segmentectomy and 112 wedge resection). From the available data, patients treated with a sublobar resection had a higher risk of local recurrence compared with patients treated with lobectomy [OR=1.89; 95% confidence interval (CI), 1.02‑3.50; P=0.04]. However, no obvious difference in local recurrence was found in a subgroup analysis of segmentectomy compared with lobectomy (OR=1.19; 95% CI, 0.68‑2.10; P=0.61). Sublobar resection was not associated with a significantly negative impact on distant recurrence (OR=1.09; 95% CI, 0.55‑2.16; P=0.796). Patients in the sublobar resection group had no significant differences in recurrence‑free survival (RFS; HR=1.43; 95% CI, 0.76‑2.69; P=0.27) and overall survival (OS; HR=0.96; 95% CI, 0.75‑1.23; P=0.77) compared with those in the lobectomy group. In the subgroup analysis of anatomic segmentectomy compared with lobectomy, there was no significant difference in RFS, with mild inter‑study heterogeneity. The current meta‑analysis suggested that segmentectomy had a comparable oncologic efficacy to lobectomy for solid‑dominant stage IA NSCLC. Therefore, segmentectomy may be a feasible alternative in selected cases of solid‑dominant stage IA NSCLC. However, these findings should be confirmed by prospective randomized controlled trials in the future.
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November-2019
Volume 11 Issue 5

Print ISSN: 2049-9450
Online ISSN:2049-9469

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  • CiteScore Rank: Q3: #250/404 Oncology
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  • SCImago Journal Rank (SJR): 0.446
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Spandidos Publications style
Guo J, Liu Y, Tian X, Ren Z, Lin J, Wang B and Liang C: 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. Mol Clin Oncol 11: 465-473, 2019
APA
Guo, J., Liu, Y., Tian, X., Ren, Z., Lin, J., Wang, B., & Liang, C. (2019). 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. Molecular and Clinical Oncology, 11, 465-473. https://doi.org/10.3892/mco.2019.1914
MLA
Guo, J., Liu, Y., Tian, X., Ren, Z., Lin, J., Wang, B., Liang, C."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". Molecular and Clinical Oncology 11.5 (2019): 465-473.
Chicago
Guo, J., Liu, Y., Tian, X., Ren, Z., Lin, J., Wang, B., Liang, C."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". Molecular and Clinical Oncology 11, no. 5 (2019): 465-473. https://doi.org/10.3892/mco.2019.1914