Abstract
BackgroundAs there is no consensus on the optimal surgery strategy for multiple primary lung cancer (MPLC), we conducted this study to address this issue by comparing the prognosis of MPLC patients underwent different surgical strategies including sublobar resection and the standard resection through a systemic review and meta-analysis.MethodsRelevant literature was obtained from three databases including PubMed, Embase and Web of Science. Inclusion and exclusion criteria were set for the screening of articles to be selected for further conduction of systemic review and meta-analysis. The HRs of OS of the sublobar group compared with standard resection group were extracted directly or calculated indirectly from included researches.ResultsTen researches published from 2000 to 2017 were included in this study, with 468 and 445 MPLC cases for the standard resection group and sublobar resection group respectively. The result suggested that OS of MPLC patients underwent sublobar resection (segmentectomy or wedge resection for at least one lesion) was comparable with those underwent standard resection approach (lobectomy or pneumonectomy for all lesions), with HR 1.07, 95% CI 0.67–1.71, p = 0.784. Further analysis found no difference in subgroups of synchronous and metachronous (from second metachronous lesion), different population region and dominant sex type.ConclusionsThis study may reveal that sublobar resection is acceptable for patients with MPLC at an early stage, because of the equivalent prognosis to the standard resection and better pulmonary function preservation. Further research is needed to validate these findings.
Highlights
As there is no consensus on the optimal surgery strategy for multiple primary lung cancer (MPLC), we conducted this study to address this issue by comparing the prognosis of MPLC patients underwent different surgical strategies including sublobar resection and the standard resection through a systemic review and metaanalysis
Literature search In total 3987 relative articles were obtained from the three databases and after screening, ten studies published from 2000 to 2017 were included for further analysis (Fig. 1)
All ten articles compared the prognosis of MPLC patients treated surgically by standard and sublobar methods (Tables 1, 2, and 3)
Summary
As there is no consensus on the optimal surgery strategy for multiple primary lung cancer (MPLC), we conducted this study to address this issue by comparing the prognosis of MPLC patients underwent different surgical strategies including sublobar resection and the standard resection through a systemic review and metaanalysis. As a special type of lung cancer, multiple primary lung cancer (MPLC) occurred on 0.2– 20% of all lung cancer cases [1]. There were some studies about surgical treatment of MPLC, it remains controversial about the prognosis of these patients and its impacting factors, such as different resection methods [6]. No consensus has been reached on whether sublobar resection (segmentectomy or wedge resection) would bring along a worse prognosis compared with standard resection (anatomical lobectomy or pneumonectomy for all lesions) for MPLC patients. We looked into the prognosis of post-operative MPLC
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