ANALYSIS OF PUBLISHED STUDIES ON THE DETECTION OF EXTRATHORACIC METASTASES IN PATIENTS PRESUMED TO HAVE OPERABLE NONSMALL CELL LUNG-CANCER
ANALYSIS OF PUBLISHED STUDIES ON THE DETECTION OF EXTRATHORACIC METASTASES IN PATIENTS PRESUMED TO HAVE OPERABLE NONSMALL CELL LUNG-CANCER
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DOI：
10.1136/thx.49.1.14
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发表时间：
1994-01-01
期刊：
影响因子：
10
通讯作者：
GUYATT, GH
中科院分区：
文献类型：
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作者：
HILLERS, TK;SAUVE, MD;GUYATT, GH
背景-进行了一项研究，以确定可能的可手术的非小细胞肺癌患者的比例，可以幸免于开胸术的系统搜索extrathoracic metastasis.Methods -英语文献检索进行了使用MEDLINE（1966年至1991年）和书目的教科书，评论文章和关键文章的评论。纳入的研究中，至少90%的患者经组织学证实患有非小细胞肺癌，被认为可以手术，并且可以获得头部或腹部计算机断层扫描、腹部超声检查或骨或肝脏放射性核素成像（扫描）的结果。研究质量和具体的描述性信息有关的人口，干预措施，和结果measurements.Results -约1500引文进行了筛选，100进行了详细审查和数据提取16。的患者数量（总数，方括号内为无症状患者的数量），调查结果直接显示不可手术，因此避免了不必要的开胸手术：头部计算机断层扫描：26/785（3.3%），95%置信区间（CI）2.1%至4.4% [14/353（4.0%），95% CI 2%-6%]，肾上腺计算机断层扫描：30/632（4.7%），95% CI 3.0%至6.4% [无症状不确定的数量]，骨扫描：45/480（9.3%），95% CI 6.7%至12% [9/301（3.0%），95% CI 1.1%至4.9%]，肝脏成像：12/529（2.3%），95% CI 0.9%至3.3% [4/268（1.5%），95% CI 0.1%至3%]。需要一项大样本量的研究，最好结合胸部计算机断层扫描，以缩小每个测试的置信区间。所有的测试可能发挥重要作用，在术前评估的非小细胞肺癌患者谁被认为是可手术的，包括无症状的患者。现有数据的局限性排除了对无症状患者的明确建议。
Background - A study was undertaken to determine the proportion of patients with potentially operable non-small cell lung cancer that could be spared thoracotomy by a systematic search for extrathoracic metastases.Methods - An English language literature search was carried out using MEDLINE (1966-91) and bibliographic reviews of textbooks, review articles, and key articles. Studies were included in which at least 90% of the patients had histologically proven non-small cell cancer of the lung, were presumed otherwise operable, and for which the results of computed tomography of the head or abdomen, ultrasonography of the abdomen, or radionuclide imaging (scan) of bone or liver were available. Study quality and specific descriptive information concerning population, intervention, and outcome measurements were assessed.Results - Of approximately 1500 citations which were screened, 100 were reviewed in detail and data abstracted from 16. The number of patients (total number, followed in square brackets by number of asymptomatic patients) shown to be inoperable directly as a result of the investigation and thus spared unnecessary thoracotomy was: computed tomography of the head: 26/785 (3.3%), 95% confidence interval (CI) 2.1% to 4.4% [14/353 (4.0%), 95% CI 2% to 6%], computed tomography of the adrenal glands: 30/632 (4.7%), 95% CI 3.0% to 6.4% [number asymptomatic indeterminate], bone scan: 45/480 (9.3%), 95% CI 6.7% to 12% [9/301(3.0%), 95% CI 1.1% to 4.9%], liver imaging: 12/529 (2.3%), 95% CI 0.9% to 3.3% [4/268 (1.5%), 95% CI 0.1% to 3%].Conclusions - A study with a large sample size and preferably incorporating thoracic computed tomography is required to narrow the confidence intervals around each test. All tests may play an important part in the preoperative evaluation of patients with non-small cell carcinoma of the lung who are presumed to be operable, including asymptomatic patients. Limitations of present data preclude definitive recommendations for asymptomatic patients.