Comparison Between Wedge Resection and Lobectomy/Segmentectomy for Early-Stage Non-small Cell Lung Cancer: A Bayesian Meta-analysis and Systematic Review.
Comparison Between Wedge Resection and Lobectomy/Segmentectomy for Early-Stage Non-small Cell Lung Cancer: A Bayesian Meta-analysis and Systematic Review.
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DOI：
10.1245/s10434-021-10857-7
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发表时间：
2022-03
影响因子：
3.7
通讯作者：
Chen X
中科院分区：
文献类型：
--
作者：
Shi Y;Wu S;Ma S;Lyu Y;Xu H;Deng L;Chen X
手术已成为治疗早期非小细胞肺癌（NSCLC）的公认方法。本贝叶斯荟萃分析的目的是比较楔形切除术与肺叶切除术/肺段切除术治疗早期NSCLC的总生存期（OS）、无病生存期（DFS）和无复发生存期（RFS）。从Web of Science、PubMed、MEDLINE、科克伦图书馆、EMBASE、CNKI和WanFang检索到截至2021年7月的合格研究，并根据既定的选择标准进行筛选。使用随机效应模型结合个体研究报告的生存结局进行贝叶斯荟萃分析。比较楔形切除组与肺叶/肺段切除组的OS、DFS和RFS。使用Kaplan-Meier方法提取或计算每项研究的风险比（HR）和标准误。 本研究已在PROSPERO注册肺段切除术和肺叶切除术之间的合并OS风险比为1.1 [95%置信区间（CI）0.92-1.4]，肺叶切除术和楔形切除术之间的合并HR为0.71 [95% CI 0.52-0.96]，肺段切除术与楔形切除术的合并HR为0.80 [95%CI 0.56-1.10]。在三种手术入路中，DFS或RFS的合并HR无统计学显著性。接受肺叶切除术的早期NSCLC患者的OS风险比低于接受楔形切除术的患者，表明接受肺叶切除术的患者的总生存率高于接受楔形切除术的患者。然而，在DFS和RFS方面，三种手术入路无显著差异。 在线版本包含补充材料，可通过10.1245/s10434-021-10857-7获得。
Surgery has become an accepted method for the treatment of early-stage non-small cell lung cancer (NSCLC). The purpose of this Bayesian meta-analysis was to compare the overall survival (OS), disease-free survival (DFS), and relapse-free survival (RFS) between wedge resection and lobectomy/segmentectomy for treatment of early-stage NSCLC. Eligible studies were retrieved from Web of Science, PubMed, MEDLINE, Cochrane Library, EMBASE, CNKI, and WanFang up to July 2021 and screened based on established selection criteria. The Bayesian meta-analysis was performed with the combination of the reported survival outcomes of the individual studies using a random-effect model. The OS, DFS, and RFS of the wedge resection group was compared with the lobectomy/segmentectomy group. The hazard ratio (HR) and standard error were extracted or calculated for each study using the Kaplan-Meier method. This study was registered with PROSPERO (INPLASY202080090).The pooled OS hazard ratio between segmentectomy and lobectomy was 1.1 [95% confidence interval (CI) 0.92–1.4], the pooled HR between lobectomy and wedge resection was 0.71 [95% CI 0.52–0.96], and the pooled HR between segmentectomy and wedge was 0.80 [95% CI 0.56–1.10]. The pooled HR of DFS or RFS was not statistically significant among the three surgical approaches. Patients with early-stage NSCLC received lobectomy had the lowest hazard ratio of OS than patients received wedge resection, indicating that the overall survival of patients received lobectomy was higher than patients received wedge resection. However, regarding DFS and RFS, the three surgical approaches showed no significant difference. The online version contains supplementary material available at 10.1245/s10434-021-10857-7.
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