| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2007;32:20-28. doi:10.1016/j.ejcts.2007.03.018
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved
Reviews |
a Department of Cardiothoracic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
b Department of Thoracic and Cardiovascular Surgery, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai 200080, China
Received 1 January 2007; received in revised form 7 March 2007; accepted 13 March 2007.
* Corresponding author. Tel.: +86 571 87783641; fax: +86 571 87022660. (Email: dr_dongaiqiang{at}sina.com).
It has been reported that sleeve lobectomy (SL) concomitant with or without pulmonary artery reconstruction (PAR) might be an alternative procedure for pneumonectomy (PN) in non-small cell lung cancer (NSCLC). The aim of this study was to assess whether SL or PN offers a low morbidity and mortality and better long-term survival. We performed a meta-analysis of studies published in English between 1996 and 2006 to comprehensively compare the postoperative mortality, morbidity, locoregional recurrences, and time-to-event outcomes of SL and PN in NSCLC, and reviewed the recent literatures on PAR in the corresponding period as well. Twelve studies met the defined criteria including a total of 2984 subjects, and five studies for PAR. The odds ratio for postoperative mortality (SL vs PN) was 0.65 (95% confidence interval (CI): 0.42–1.01), 1.01 (95% CI: 0.70–1.44) for postoperative complications, and 0.91 (95% CI: 0.45–1.82) for locoregional recurrences. The weighted mean operative mortality for PAR was 3.3%, and 32.4% for complications. The estimated combined hazard ratio for overall survival in 10 studies was 0.70 (95% CI: 0.62–0.79) in favor of SL group. The median overall survival was 60 months for the SL group, 26 months for the PN group, and 30 months for PAR group. Survival difference in patients with pN0 or pN1 at 1 year demonstrated a pooled risk difference (SL vs PN) of 0.03 (95% CI: –0.08–0.13), 0.13 (95% CI: 0.00–0.25) in patients with pN2 at 1 year, 0.21 (95% CI: 0.07–0.36) in patients with pN0 or pN1 at 5 years, and 0.06 (95% CI: –0.10–0.21) in patients with pN2 at 5 years. Our results suggests that SL with or without PAR can be accomplished safely in selected patients without increasing the morbidity and mortality as compared to PN, that SL even with PAR offers better long-term survival than does PN, and that a more radical operation such as PN is not a more appropriate procedure, even in higher stage tumors.
Key Words: Meta-analysis • Sleeve lobectomy • Pneumonectomy • Morbidity and mortality • Survival analysis • Non-small cell lung cancer
This article has been cited by other articles:
|
|
 |
|
  E. Melloul, B. Egger, T. Krueger, C. Cheng, F. Mithieux, C. Ruffieux, L. Magnusson, and H.-B. Ris Mortality, complications and loss of pulmonary function after pneumonectomy vs. sleeve lobectomy in patients younger and older than 70 years Interactive CardioVascular and Thoracic Surgery, December 1, 2008; 7(6): 986 - 989. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Rea, G. Marulli, M. Schiavon, A. Zuin, A.-M. Hamad, G. Rizzardi, E. Perissinotto, and F. Sartori A quarter of a century experience with sleeve lobectomy for non-small cell lung cancer Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 488 - 492. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Gudbjartsson, E. Gyllstedt, A. Pikwer, and P. Jonsson Early surgical results after pneumonectomy for non-small cell lung cancer are not affected by preoperative radiotherapy and chemotherapy. Ann. Thorac. Surg., August 1, 2008; 86(2): 376 - 382. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
