Survival outcomes of Segmentectomy and Lobectomy for early stage non-small cell lung cancer: a Systematic Review and Meta-analysis

Abstract Background The question of whether segmentectomy and lobectomy have similar survival outcomes for patients with early stage non-small cell lung cancer (NSCLC) is a matter of debate. Methods A cohort study and randomized controlled trial were conducted, comparing segmentectomy and lobotomy, by utilizing computerized access to the Pubmed, Web of Science, and Cochrane Library databases up until July 2022. The Cochrane Collaboration tool was used to evaluate the randomized controlled trials, while the Newcastle-Ottawa Scale (NOS) was used to evaluate the cohort studies. Sensitivity analyses were also carried out. Results The analysis incorporated 18 literature studies, including one randomized controlled trial and 17 cohort studies, and was divided into a segmentectomy group (n = 2081) and a lobectomy group (n = 2395) based on the type of surgery the patient underwent. Each study was followed up from 27 months to 130.8 months after surgery. OS:HR = 1.14, 95%CI(0.97,1.32), P = 0.10; DFS:HR = 1.13, 95%CI(0.91,1.41), P = 0.27; RFS:HR = 0.95, 95%CI(0.81,1.12), P = 0.54. Conclusion The results of the study suggest that the survival outcomes of the segmentectomy group were not inferior to that of the lobectomy group. Segmentectomy should therefore be considered as a treatment option for early stage NSCLC.