Analyzing the surgical resection of lung cancer

Background: Lung cancer is the leading cause of cancer deaths worldwide, compounded by late diagnosis. Tumor resection by surgery has been performed for selected lung cancer patients in specialized centers over the last century. Despite encouraging results from case-series reports, there remains a lack of robust clinical analysis of prevalent surgical techniques, especially in cases of pre- and post-operative smokers. The present systematic review and meta-analysis aimed to assess the different surgical techniques, their success rate and the various compounding factors that dictate the success of the intervention. Methods: A systematic search was performed using Ovid; Medline & E mbase, EBSCO; CINHAL, PsychINFO & SocINDEX and Cochrane Library databases to identify relevant studies. Results and conclusions: The identified studies were too heterogeneous to be combined using a formal meta-analysis. Therefore, a narrative synthesis was performed. Advances in operative and postoperative care have led to a decline in complications; however, mortality rates during the last decades have increased due to incidence of associated co-morbidity. The optimal timing of smoking cessation before lung resection is not known; however, it is highly recommended that lung cancer patients completely quit smoking to enhance the effectiveness of both surgical and chemotherapeutic treatment. There is a need to conduct more methodologically sound studies.