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Year : 2016  |  Volume : 12  |  Issue : 2  |  Page : 926-931

Comparison of clinical outcomes after thoracoscopic sublobectomy versus lobectomy for Stage I nonsmall cell lung cancer: A meta-analysis

1 Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
2 Department of The Third Surgery, Dujiangyan Medical Center, Chengdu 611800, China

Correspondence Address:
Jigang Dai
Department of Thoracic Surgery, Xinqiao Hospital, The Third Military Medical University, No. 183 Xinqiao Positive Street, Chongqing 400037
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1482.174181

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Background: Although lobectomy has long been considered the standard procedure for Stage I nonsmall cell lung cancer (NSCLC), the selection of sublobectomy for Stage I NSCLC remains controversial. Amidst growing enthusiasm for minimally invasive surgery, the comparison of clinical outcomes after thoracoscopic sublobectomy versus thoracoscopic lobectomy may be of immense value. Objective: The present study aimed to compare the overall survival (OS) and disease-free survival (DFS) outcomes of patients who underwent thoracoscopic sublobectomy with those who underwent thoracoscopic lobectomy for Stage I NSCLC. Methods: An electronic search was conducted using five online databases from their dates of inception to February 2014. Hazard ratio (HR) was used in this meta-analysis, calculated from the published survival data. Results: Eight studies met the selection criteria, including a total of 1613 patients (463 patients underwent thoracoscopic sublobectomy, and 1150 patients underwent thoracoscopic lobectomy). From the available data, compared with thoracoscopic sublobectomy, there was a significant benefit of thoracoscopic lobectomy on OS (HR: 1.45; 95% confidence interval [CI]: 1.11–1.90; P = 0.007). However, in subgroup analysis of thoracoscopic segmentectomy and thoracoscopic lobectomy, there was no significant difference in OS (HR: 1.03; 95% CI: 0.76–1.39; P = 0.85) or DFS (HR: 1.19; 95% CI: 0.67–2.10; P = 0.56) between the two groups. In addition, compared with thoracoscopic wedge resection, there was a significant benefit of thoracoscopic lobectomy on OS (HR: 4.19; 95% CI: 2.19–8.03, P < 0.0001). Conclusion: For Stage I patients, thoracoscopic segmentectomy leads to survival rates comparable to thoracoscopic lobectomy. However, the overall several of thoracoscopic lobectomy is superior to that of wedge resection.

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