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Long-Term Survival after Extended Sleeve Lobectomy (ESL) for Central Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis with Reconstructed Time-to-Event Data

Objective: We conducted a thorough literature search on patients with central non-small cell lung cancer (NSCLC) undergoing either extended sleeve lobectomy (ESL) or pneumonectomy (PN). Methods: We identified all original research studies that compared the long-term survival of ESL versus PN from 19...

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Autores principales: Magouliotis, Dimitrios E., Zotos, Prokopis-Andreas, Karamolegkou, Anna P., Tatsios, Evangelos, Spiliopoulos, Kyriakos, Athanasiou, Thanos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821210/
https://www.ncbi.nlm.nih.gov/pubmed/36615005
http://dx.doi.org/10.3390/jcm12010204
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author Magouliotis, Dimitrios E.
Zotos, Prokopis-Andreas
Karamolegkou, Anna P.
Tatsios, Evangelos
Spiliopoulos, Kyriakos
Athanasiou, Thanos
author_facet Magouliotis, Dimitrios E.
Zotos, Prokopis-Andreas
Karamolegkou, Anna P.
Tatsios, Evangelos
Spiliopoulos, Kyriakos
Athanasiou, Thanos
author_sort Magouliotis, Dimitrios E.
collection PubMed
description Objective: We conducted a thorough literature search on patients with central non-small cell lung cancer (NSCLC) undergoing either extended sleeve lobectomy (ESL) or pneumonectomy (PN). Methods: We identified all original research studies that compared the long-term survival of ESL versus PN from 1990 to 2022. The primary endpoints were the median overall survival (OS) and disease-free survival (DFS). Complications, operative mortality, and the reoperation rate were the secondary endpoints. Regarding the primary endpoints, independent patient data were extracted from the included studies, and pooled Kaplan–Meier curves were constructed. A sensitivity analysis was performed using the leave-one-out method. Results: Nine studies were included in the qualitative and seven in the quantitative synthesis, including 431 patients. Patients in the ESL group demonstrated a significantly higher OS compared with the PN group (HR, 0.63; 95% CI, 0.46–0.87; p = 0.005). In addition, patients undergoing ESL presented a significantly higher DFS compared to the PN group (HR, 0.57; 95% CI, 0.40–0.80; p = 0.004). These findings were further validated with a sensitivity analysis. The most common complications in the ESL group were bronchopleural fistula (4.6%), stricture (3.1%), prolonged air leakage (7.3%), sputum retention (4.6%), pneumonia (7.7%), and pulmonary vein thrombosis (1.5%). ESL was associated with a low reoperation rate (1.5%) and operative mortality (1.2%). Conclusions: The present meta-analysis indicates that ESL is associated with enhanced survival outcomes compared to PN for patients with central NSCLC. Further randomized controlled trials are necessary to validate our findings.
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spelling pubmed-98212102023-01-07 Long-Term Survival after Extended Sleeve Lobectomy (ESL) for Central Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis with Reconstructed Time-to-Event Data Magouliotis, Dimitrios E. Zotos, Prokopis-Andreas Karamolegkou, Anna P. Tatsios, Evangelos Spiliopoulos, Kyriakos Athanasiou, Thanos J Clin Med Systematic Review Objective: We conducted a thorough literature search on patients with central non-small cell lung cancer (NSCLC) undergoing either extended sleeve lobectomy (ESL) or pneumonectomy (PN). Methods: We identified all original research studies that compared the long-term survival of ESL versus PN from 1990 to 2022. The primary endpoints were the median overall survival (OS) and disease-free survival (DFS). Complications, operative mortality, and the reoperation rate were the secondary endpoints. Regarding the primary endpoints, independent patient data were extracted from the included studies, and pooled Kaplan–Meier curves were constructed. A sensitivity analysis was performed using the leave-one-out method. Results: Nine studies were included in the qualitative and seven in the quantitative synthesis, including 431 patients. Patients in the ESL group demonstrated a significantly higher OS compared with the PN group (HR, 0.63; 95% CI, 0.46–0.87; p = 0.005). In addition, patients undergoing ESL presented a significantly higher DFS compared to the PN group (HR, 0.57; 95% CI, 0.40–0.80; p = 0.004). These findings were further validated with a sensitivity analysis. The most common complications in the ESL group were bronchopleural fistula (4.6%), stricture (3.1%), prolonged air leakage (7.3%), sputum retention (4.6%), pneumonia (7.7%), and pulmonary vein thrombosis (1.5%). ESL was associated with a low reoperation rate (1.5%) and operative mortality (1.2%). Conclusions: The present meta-analysis indicates that ESL is associated with enhanced survival outcomes compared to PN for patients with central NSCLC. Further randomized controlled trials are necessary to validate our findings. MDPI 2022-12-27 /pmc/articles/PMC9821210/ /pubmed/36615005 http://dx.doi.org/10.3390/jcm12010204 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Magouliotis, Dimitrios E.
Zotos, Prokopis-Andreas
Karamolegkou, Anna P.
Tatsios, Evangelos
Spiliopoulos, Kyriakos
Athanasiou, Thanos
Long-Term Survival after Extended Sleeve Lobectomy (ESL) for Central Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis with Reconstructed Time-to-Event Data
title Long-Term Survival after Extended Sleeve Lobectomy (ESL) for Central Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis with Reconstructed Time-to-Event Data
title_full Long-Term Survival after Extended Sleeve Lobectomy (ESL) for Central Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis with Reconstructed Time-to-Event Data
title_fullStr Long-Term Survival after Extended Sleeve Lobectomy (ESL) for Central Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis with Reconstructed Time-to-Event Data
title_full_unstemmed Long-Term Survival after Extended Sleeve Lobectomy (ESL) for Central Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis with Reconstructed Time-to-Event Data
title_short Long-Term Survival after Extended Sleeve Lobectomy (ESL) for Central Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis with Reconstructed Time-to-Event Data
title_sort long-term survival after extended sleeve lobectomy (esl) for central non-small cell lung cancer (nsclc): a meta-analysis with reconstructed time-to-event data
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821210/
https://www.ncbi.nlm.nih.gov/pubmed/36615005
http://dx.doi.org/10.3390/jcm12010204
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