Is sleeve lobectomy safe after induction therapy?-a systematic review and meta-analysis.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
ID Serval
serval:BIB_AC8BE5624D74
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Is sleeve lobectomy safe after induction therapy?-a systematic review and meta-analysis.
Périodique
Journal of thoracic disease
Auteur⸱e⸱s
Chriqui L.E., Forster C., Lovis A., Bouchaab H., Krueger T., Perentes J.Y., Gonzalez M.
ISSN
2072-1439 (Print)
ISSN-L
2072-1439
Statut éditorial
Publié
Date de publication
10/2021
Peer-reviewed
Oui
Volume
13
Numéro
10
Pages
5887-5898
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Sleeve lobectomy (SL) is a lung-sparing procedure, which is accepted as a valid operation for centrally-located advanced tumors. These tumors often require induction treatment by chemotherapy and/or radiotherapy to downstage the disease and thus facilitate subsequent surgery. However, induction therapy may potentially increase the risk of bronchial anastomotic complications and related morbidity. This meta-analysis aims to determine the impact of induction therapy on the outcomes of pulmonary SL.
We compared studies of patients undergoing SL or bilobectomy for non-small cell lung cancer (NSCLC) with and without induction therapy. Outcomes of interest were in-hospital mortality, morbidity, anastomosis complication and 5-year survival. Odds ratio (OR) were computed following the Mantel-Haenszel method.
Ten studies were included for a total of 1,204 patients. There was no statistical difference for between patients who underwent induction therapy followed by surgery and patients who underwent surgery alone in term of post-operative mortality (OR: 1.80, 95% confidence interval (CI): 0.76-4.25, P value =0.19) and morbidity (OR: 1.17, 95% CI: 0.90-1.52, P value =0.237). Anastomosis related complications rate were 5.2% and appears increased after induction therapy with a statistical difference close to the significance (OR: 1.65, 95% CI: 0.97-2.83, P value =0.06). Patients undergoing surgery alone showed better survival at 5 years (OR: 1.52, 95% CI: 1.15-2.00, P value =0.003).
SL following induction therapy can be safely performed with no increase of mortality and morbidity. However, the need for induction therapy before surgery is associated with increased anastomotic complications and poorer survival prognosis at 5 years.
Mots-clé
Sleeve lobectomy (SL), induction therapy, anastomosis complication, survival, thoracic surgery
Pubmed
Web of science
Open Access
Oui
Création de la notice
01/10/2021 17:05
Dernière modification de la notice
29/06/2023 6:38
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