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P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Presentations: 1
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
P3.01-59 - Comparison of Lobectomy, Segmentectomy and Wedge Resection for Early Stage NSCLC: A Direct and Network Meta-Analysis (ID 12396)
12:00 - 13:30 | Presenting Author(s): Wang Liang
Aim: The purpose of this study was to compare the effect of lobectomy, segmentectomy and wedge resection for early stage non-small cell lung cancer (NSCLC) treatment.
surgical section is a first choice for surgical treatment of early stage NSCLC (5). However, it is not applied for most NSCLC with advanced stages owing to its high metastasis and recurrence rates . In addition, video-assisted thoracoscopic surgery (VATS) as a less invasive surgical method is widely used for clinical stage I NSCLC during lobectomy, segmentectomy, and wedge resection .
Lobectomy is a traditionally gold standard for early stage NSCLC treatment . In recent years, segmentectomy and wedge resection as alternative sublobar resection to lobectomy are recommended. Many studies have indicated that sublobar resection results in equivalent outcomes in patients with stage I NSCLC in comparison with lobectomy, and it is gradually considered that pneumonectomy is unnecessary . However, sublobar resection for NSCLC treatment remains controversial due to an increased risk in local recurrence and poorer long-term survival compared to lobectomy, thus additional local therapy is recommended to patients undergoing sublobar resection .
Eligible studies were retrieved from PubMed, Embase, and Cochrane Library. The 1, 2 or 5-year overall survival (OS) and disease-free survival (DFS), and complications rates were used as outcomes indictors. The pooled results for comparison indicators were measured by odds ratios (ORs) with 95% confidence interval (CI) as dichotomous variables. The random effects model was used for all test models in the present study. The consistency assessment in this network meta-analysis was conducted by Node-splitting analysis.4c3880bb027f159e801041b1021e88e8 Result
A total of 23 studies encompassing 13406 early stage NSCLC patients were included into this network meta-analysis. The results revealed that although 1, 2 and 5-year OS and DFS of lobetomy was superior to segmentectomy and wedge resection, and segmentectomy was better than wedge resection, except for 2-year OS, only result of 5-years OS between groups (wedge resection vs. segmentectomy, OR= 0.56, 95%CI: 0.36-0.87; wedge resection vs. lobetomy, OR= 0.51, 95%CI: 0.33-0.79) were significant difference. On the contrary, the complications rate in wedge resection was significant lower than that of lobetomy (lobetomy vs. wedge resection, OR= 1.73, 95%CI: 1.05-2.72) and segmentectomy (segmentectomy vs. wedge resection, OR= 1.66, 95%CI: 1.02-2.74), and it was highest in lobetomy.8eea62084ca7e541d918e823422bd82e Conclusion
Segmentectomy might be recommended as a reasonable alternative to lobectomy with lower complications rate for early stage NSCLC treatment.6f8b794f3246b0c1e1780bb4d4d5dc53