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Systematic Mediastinal Lymphadenectomy or Mediastinal Lymph Node Sampling in Patients With Pathological Stage I NSCLC: A Meta-Analysis

Abstract

Background

To evaluate the evidence comparing systematic mediastinal lymphadenectomy (SML) and mediastinal lymph node sampling (MLS) in the treatment of pathological stage I NSCLC using meta-analytical techniques.

Methods

A literature search was undertaken until January 2014 to identify the comparative studies evaluating 1-, 3-, and 5-year survival rates. The pooled odds ratios (OR) and the 95 % confidence intervals (95 % CI) were calculated with either the fixed or random effect models.

Results

One RCT study and four retrospective studies were included in our meta-analysis. These studies included a total of 711 patients: 317 treated with SML, and 394 treated with MLS. The SML and the MLS did not demonstrate a significant difference in the 1-year survival rate. There were significant statistical differences between the 3-year (P = 0.03) and 5-year survival rates (P = 0.004), which favored SML.

Conclusions

This meta-analysis suggests that in pathological stage I NSCLC, the MLS can get the similar outcome to the SML in terms of 1-year survival rate. However, the SML is superior to MLS in terms of 3- and 5-year survival rates.

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Correspondence to Lin Zhang.

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Dong, S., Du, J., Li, W. et al. Systematic Mediastinal Lymphadenectomy or Mediastinal Lymph Node Sampling in Patients With Pathological Stage I NSCLC: A Meta-Analysis. World J Surg 39, 410–416 (2015). https://doi.org/10.1007/s00268-014-2804-8

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  • DOI: https://doi.org/10.1007/s00268-014-2804-8

Keywords

  • Pathological Stage
  • Fixed Effect Model
  • Lung Cancer Screening
  • Mediastinal Lymph Node Involvement
  • Z0030 Study