Stage I and II Small-Cell Lung Cancer-New Challenge for Surgery

被引:11
作者
Doerr, Fabian [1 ]
Stange, Sebastian [2 ]
Michel, Maximilian [3 ]
Schlachtenberger, Georg [1 ]
Menghesha, Hruy [1 ]
Wahlers, Thorsten [1 ]
Hekmat, Khosro [1 ]
Heldwein, Matthias B. [1 ]
机构
[1] Univ Cologne, Univ Hosp Cologne, Dept Cardiothorac Surg, Kerpener Str 62, D-50931 Cologne, Germany
[2] Regiomed Klinikum Coburg GmbH, Dept Thorac Surg, Coburg, Germany
[3] Univ Cologne, Inst Zool, Fac Math & Nat Sci, Cologne, Germany
关键词
Small-cell lung cancer; Surgery; Meta-analysis; Mean-survival; SURGICAL RESECTION; SURVIVAL OUTCOMES; AMERICAN-COLLEGE; MANAGEMENT; CARCINOMA; CHEMOTHERAPY; RADIOTHERAPY; DIAGNOSIS; PROGNOSIS; LOBECTOMY;
D O I
10.1007/s00408-022-00549-8
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Purpose The recommended treatment for small-cell lung cancer (SCLC) currently is surgery in stage I disease. We wondered about stage II SCLC and present a meta-analysis on mean-survival of patients that underwent surgery for stage I and II compared to controls. Methods A systematic literature search was performed on December 01st 2021 in Medline, Embase and Cochrane Library. We considered studies published on the effect of surgery in SCLC since 2004 and assessed them using ROBINS-I. We preformed I-2-tests, Q-statistics, DerSimonian-Laird tests and Egger-regression. The meta-analysis was conducted according to PRISMA. Results Out of 6826 records, seven studies with a total of 11,241 patients ('surgery group': 3911 patients; 'non-surgery group': 7330; treatment period: 1984-2015) were included. Heterogeneity between the studies was revealed in absence of any publication bias. Patient characteristics did not differ between the groups (p-value > 0.05). The mean-survival in an analysis of patients in stage I was 36.7 +/- 10.8 months for the 'surgery group' and 20.3 +/- 5.7 months for the 'non-surgery group' (p-value = 0.0084). A combined analysis of patients in stage I and II revealed a mean-survival of 32.0 +/- 16.7 months for the 'surgery group' and 19.1 +/- 6.1 months for the 'non-surgery group' (p-value = 0.0391). In a separate analysis of stage II, we were able to demonstrate a significant survival benefit after surgery (21.4 +/- 3.6 versus 16.2 +/- 3.9 months; p-value = 0.0493). Conclusion Our meta-analysis shows a significant survival benefit after surgery not only in the recommended stage I but also in stage II SCLC. Our data suggests that both stages should be considered for surgery of early SCLC.
引用
收藏
页码:505 / 512
页数:8
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