Universität zu Köln

Doerr, Fabian ORCID: 0000-0002-0878-0406, Stange, Sebastian, Michel, Maximilian, Schlachtenberger, Georg, Menghesha, Hruy, Wahlers, Thorsten, Hekmat, Khosro and Heldwein, Matthias B. (2022). Redefining the role of surgery in early small-cell lung cancer. Langenbecks Arch. Surg., 407 (7). S. 2663 - 2672. NEW YORK: SPRINGER. ISSN 1435-2451

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Abstract

Purpose Resection is guideline recommended in stage I small-cell lung cancer (SCLC) but not in stage II. In this stage, patients are treated with a non-surgical approach. The aim of this meta-analysis was to assess the role of surgery in both SCLC stages. Surgically treated patients were compared to non-surgical controls. Five-year survival rates were analysed. Methods A systematic literature search was performed on December 01, 2021 in Medline, Embase and Cochrane Library. Studies published since 2004 on the effect of surgery in SCLC were considered and assessed using ROBINS-I. We preformed I-2-tests, Q-statistics, DerSimonian-Laird tests and Egger-regression. The meta-analysis was conducted according to PRISMA. Results Out of 6826 records, we identified seven original studies with a total of 15,170 patients that met our inclusion criteria. We found heterogeneity between these studies and ruled out any publication bias. Patient characteristics did not significantly differ between the two groups (p-value > 0.05). The 5-year survival rates in stage I were 47.4 +/- 11.6% for the 'surgery group' and 21.7 +/- 11.3% for the 'non-surgery group' (p-value = 0.0006). Our analysis of stage II SCLC revealed a significant survival benefit after surgery (40.2 +/- 21.6% versus 21.2 +/- 17.3%; p-value = 0.0474). Conclusion Based on our data, the role of surgery in stage I and II SCLC is robust, since it improves the long-term survival in both stages significantly. Hence, feasibility of surgery as a priority treatment should always be evaluated not only in stage I SCLC but also in stage II, for which guideline recommendations might have to be reassessed.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Doerr, Fabian UNSPECIFIED orcid.org/0000-0002-0878-0406 UNSPECIFIED Stange, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Michel, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlachtenberger, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Menghesha, Hruy UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Hekmat, Khosro UNSPECIFIED UNSPECIFIED UNSPECIFIED Heldwein, Matthias B. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-665442
DOI:	10.1007/s00423-022-02631-4
Journal or Publication Title:	Langenbecks Arch. Surg.
Volume:	407
Number:	7
Page Range:	S. 2663 - 2672
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1435-2451
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SURGICAL RESECTION; STAGE; MANAGEMENT; SURVIVAL; TERM; RADIOTHERAPY; PROGNOSIS; LOBECTOMY; CARCINOMA; EFFICACY Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66544