Survival analysis of surgical versus nonsurgical treatment in stage I to III small cell lung cancer in the last 20  years: A systematic review and meta‐analysis

AbstractMore and more patients with small cell lung cancer (SCLC) have received surgical treatment in the last 20  years. This meta-analysis compared whether surgical treatment can bring greater survival benefits to patients with stage I–III SCLC compared with chemotherapy, radiotherapy and chemoradiotherapy. Pubmed, Embase, Web of Science, Cochrane library database, and ClinicalTrials were searched for rel evant articles. The main outcomes were overall survival (OS), reported as hazard ratios (HRs), and 95% confidence intervals (CIs). A total of 19 articles containing 30 185 patients (3940 patients receiving surgical treatment and 26 245 patients receiving nonsurgical treatment) were included in t his study. Surgical resection significantly improved OS when compared to nonsurgical treatment in retrospective studies (HR: 0.55, 95% CI: 0.47–0.64,p <  0.01). In the subgroup analysis for retrospective studies, surgical resection was associated with superior OS in stage I (HR: 0.42, 95% CI: 0.24–0.71,p <  0.01), stage II (HR: 0.61, 95% CI: 0.52–0.73,p <  0.01), and stage III diseases (HR: 0.66, 95% CI: 0.51–0.86,p <  0.01). Sublobar resection resulted in worse OS than a lobectomy (HR: 0.78,95% CI: 0.60–1.00,p <  0.01) for patients undergoing surgical resection. Compared with nonsurgical treatment, surgical treatment can indeed bring more significant survival benefits to patients with stage I–III SCLC, and lobectomy ...
Source: Thoracic Cancer - Category: Cancer & Oncology Authors: Tags: REVIEW Source Type: research