scholarly journals Effects of Vessel Interruption Sequence During Lobectomy for Non-small Cell Lung Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiang Long ◽  
Bingxuan Wu ◽  
Wenxiong Zhang ◽  
Guoli Lv ◽  
Dongliang Yu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Meta Analysis ◽  
Small Cell ◽  
Stage I ◽  
Perioperative Outcomes ◽  
Cochrane Library ◽  
Small Cell Lung ◽  
Artery First

Background: For lobectomy in non-small cell lung cancer (NSCLC), whether interrupting the pulmonary vein first (Vein-first) achieves better perioperative and survival outcomes than interrupting the pulmonary artery first (Artery-first) remains controversial. We conducted this meta-analysis to compare outcomes between the two groups to facilitate better surgical decision-making.Methods: Web of Science, EMBASE, Cochrane Library, Ovid MEDLINE, PubMed, ScienceDirect, and Scopus were searched for eligible studies comparing Vein-first and Artery-first procedures. The primary endpoints were survival indicators [overall survival (OS), disease-free survival (DFS), and lung cancer-specific survival (LCSS)]. Secondary endpoints included intraoperative indicators, hospitalization, and follow-up indicators.Results: After screening 2,505 studies, 8 studies involving 1,714 patients (Vein-First group: 881 patients; Artery-first group: 833 patients) were included. The vein-first group achieved better OS [HR (hazard ratio): 1.46, 95% confidence interval (CI): 1.12–1.91, p = 0.005], DFS (HR: 1.60, 95% CI: 1.23–2.08, p < 0.001), and LCSS (HR: 1.64, 95% CI: 1.16–2.31, p = 0.005). The survival rates of OS at 2–5 years, DFS at 1–5 years, and LCSS at 3–5 years were also higher in the Vein-First group. Subgroup analyses suggested that the advantages of survival in the Vein-First group were primarily embodied in the subgroups of squamous cell carcinoma (SCC) and earlier pathological TNM stage (I–II). Operative time, intraoperative blood loss, total complications, and total recurrences were comparable between the two groups.Conclusions: The Vein-first sequence is the suitable choice of vessel interruption sequence during lobectomy for NSCLC with better survival and similar perioperative outcomes, especially for stage I–II SCC.

scholarly journals Sublobar Resection Versus Ablation for Stage I Non-Small-Cell Lung Cancer: A Meta-Analysis

2021 ◽  
Author(s):  
Yong Li ◽  
Fang Yang ◽  
Ya-Yong Huang ◽  
Tao Wang
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Meta Analysis ◽  
Small Cell ◽  
Stage I ◽  
Cochrane Library ◽  
Complication Rates ◽  
Sublobar Resection ◽  
Small Cell Lung

Abstract BackgroundStage I non-small-cell lung cancer (NSCLC) can be treated by both ablation and sublobar resection (SR). This meta-analysis was therefore designed to better compare the relative safety and efficacy of these two approaches to treating stage I NSCLC.Materials and MethodsRelevant studies published through November 2020 in the Cochrane Library, Embase, and PubMed databases were identified for analyses which were conducted with RevMan v5.3. ResultsIn total, 816 potentially relevant articles were identified, of which 8 were ultimately included in the final meta-analysis. Patients in the SR group exhibited a signficantly lower pooled local recurrence (LR) rate (5.0% vs. 25.4%, P < 0.0001), although pooled distant recurrence (DR) rates were similar in both groups (25.7% vs. 23.1%, P = 0.75). The pooled hazard ratio (HR) for overall survival (OS) (HR: 1.23; 95% CI: 1.13-1.33, P < 0.00001), progression-free survival (PFS) (HR: 1.34; 95% CI: 1.15-1.55, P = 0.0002), and cancer-specific survival (CSS) (HR: 1.39; 95% CI: 1.15-1.70, P = 0.0009) all indicated better survival outcomes among patients that underwent HR treatment, while pooled complication rates were similar in both groups (27.7% vs. 43.8%, P = 0.27). Patients that underwent ablation exhibited significantly shorter pooled post-operative hospitalization relative to those in the SR group (MD: 5.93; 95% CI: 0.78-11.07, P = 0.02). No evidence of publication bias was detected through funnel plot analyses.ConclusionsSR treatment of stage I NSCLC patients was associated with a lower LR rate and longer survival as compared to ablation.

scholarly journals Prognostic Value of MTV and TLG of 18F-FDG PET in Patients with Stage I and II Non-Small-Cell Lung Cancer: a Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Weibo Wen ◽  
Yongnan Piao ◽  
Dongyuan Xu ◽  
Xiangdan Li
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Small Cell ◽  
Stage I ◽  
Cochrane Library ◽  
Small Cell Lung ◽  
18F Fdg

Purpose. The present systematic literature review and meta-analysis focused on examining the significance of total lesion glycolysis (TLG) and metabolic tumor volume (MTV) in predicting the prognosis of stages I/II non-small-cell lung cancer (NSCLC) based on 18F-FDG PET parameters. Methods. Electronic databases, including Cochrane Library, PubMed, and EMBASE, were comprehensively searched for retrieving relevant articles published in the English language. Furthermore, the significance of TLG and MTV in prognosis prediction was analyzed by pooled hazard ratios (HRs). Results. This work enrolled eight primary studies with 1292 I/II-stage NSCLC cases. The pooled HR (95% confidence interval [CI]) for the ability of increased TLG to predict progression-free survival (PFS) was 2.02 (1.30–2.13) ( P = 0.350 ), while for increased MTV it was 3.04 (1.92–4.81) ( P = 0.793 ). In addition, the pooled HR (95% CI) for the ability of increased TLG to predict overall survival (OS) was 2.16 (1.49–3.14) ( P = 0.624 ). However, higher MTV correlated with OS, and sensitivity analysis showed that the results were not stable. Multivariate and univariate analyses by subgroup analyses stratified by PFS of MTV and OS of TLG exhibited statistically significant differences, without any statistical heterogeneity across various articles. Conclusion. The present work suggests the predictive value of PET/CT among stage I and II NSCLC patients. Our results verified that stage I/II NSCLC cases with increased TLG and MTV had a higher risk of side reactions, and TLG is related to increased mortality risk.

scholarly journals Segmentectomy versus lobectomy for stage I non-small cell lung cancer: a systematic review and meta-analysis

2017 ◽  
Vol 9 (6) ◽  
pp. 1615-1623 ◽  
Author(s):  
Benedetta Bedetti ◽  
Luca Bertolaccini ◽  
Raffaele Rocco ◽  
Joachim Schmidt ◽  
Piergiorgio Solli ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Meta Analysis ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung

scholarly journals Segmentectomy or lobectomy for early-stage non-small-cell lung cancer: a systematic review and meta-analysis

2020 ◽  
Vol 57 (6) ◽  
pp. 1051-1060 ◽  
Author(s):  
Thomas Winckelmans ◽  
Herbert Decaluwé ◽  
Paul De Leyn ◽  
Dirk Van Raemdonck
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Meta Analysis ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Oncological Outcomes ◽  
Stage Ia

Abstract OBJECTIVES The role of segmentectomy in early-stage non-small-cell lung cancer (NSCLC) remains a matter of debate. We performed a meta-analysis to evaluate the oncological outcomes following segmentectomy versus lobectomy for stage I, stage IA only and stage IA &lt;2 cm only. METHODS We systematically searched the literature for articles reporting on overall survival (OS), cancer-specific survival (CSS) or recurrence-free survival (RFS). The hazard ratios (HRs) were retrieved and pooled using an inverse variance-weighted approach. RESULTS Twenty-eight studies were included in the analysis. In stage I, segmentectomy was found to be inferior to lobectomy for all 3 outcomes with HR: 1.25 (P = 0.01) for OS, 1.59 (P = 0.02) for CSS and 1.40 (P &lt; 0.001) for RFS. In stage IA, the differences were significant for OS and CSS, though not for RFS with HR: 1.31 (P = 0.04), 1.56 (P = 0.02) and 1.22 (P = 0.11), respectively. In stage IA &lt;2 cm, no significant differences were found between segmentectomy and lobectomy with HR: 1.13 (P = 0.37) for OS, 1.02 (P = 0.95) for CSS and 1.24 (P = 0.11) for RFS. CONCLUSIONS For stages I and IA, lobectomy showed superior results whereas for tumours &lt;2 cm, our study did not find significant differences in oncological outcomes between both groups. These results suggest that segmentectomy might be a valuable alternative to lobectomy for NSCLC in tumours &lt;2 cm.

scholarly journals Prognostic role of the advanced lung cancer inflammation index in cancer patients: a meta-analysis

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Xin Hua ◽  
Jing Chen ◽  
Ying Wu ◽  
Jun Sha ◽  
Shuhua Han ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Meta Analysis ◽  
Small Cell ◽  
Advanced Lung Cancer ◽  
Cochrane Library ◽  
Small Cell Lung ◽  
Cancer Inflammation

Abstract Background Inflammation plays a critical role in the development and progression of cancers. The advanced lung cancer inflammation index (ALI) is thought to be able to reflect systemic inflammation better than current biomarkers. However, the prognostic significance of the ALI in various types of cancer remains unclear. Our meta-analysis aimed to comprehensively investigate the relationship between the ALI and oncologic outcomes to help physicians better assess the prognosis of cancer patients. Methods The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched for relevant studies. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated and pooled from the included studies. Furthermore, a sensitivity analysis was performed to evaluate the reliability of the articles. Finally, Begg’s test, Egger’s test, and the funnel plot were applied to assess the significance of publication bias. Results In total, 1736 patients from nine studies were included in our meta-analysis. The median cutoff value for the ALI was 23.2 (range, 15.5–37.66) in the analyzed studies. The meta-analysis showed that there was a statistically significant relationship between a low ALI and worse overall survival (OS) in various types of cancer (HR = 1.70, 95% CI = 1.41–1.99, P < 0.001). Moreover, results from subgroup meta-analysis showed that the ALI had a significant prognostic value in non-small cell lung cancer, small cell lung cancer, colorectal cancer, head and neck squamous cell carcinoma, and diffuse large B cell lymphoma (P < 0.05 for all). Conclusions These results showed that a low ALI was associated with poor OS in various types of cancer, and the ALI could act as an effective prognostic biomarker in cancer patients.

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