Objectives We performed a systematic review and meta-analysis of outcomes of lobectomy versus sublobar resection in elderly patients (≥65) with stage 1 nonsmall cell lung carcinoma (NSCLC).

Methods We searched for relevant articles using a set of inclusion and exclusion criteria. Meta-analytic techniques were applied.

Results Twelve studies (n = 5834) were chosen. Our results indicate that in the elderly, lobectomy for stage 1 NSCLC confers a survival advantage over sublobar resection. Lobectomy patients had a lower risk of death within 5 years and lower odds of local cancer recurrence. Our results show that lobectomy had a better 5-year cancer-specific survival and 5-year disease-free survival that trended toward significance. The sublobar resection group showed better 30-day operative mortality that trended toward significance. Subgroup analysis of stage 1A cancer demonstrated no difference in 5-year overall survival rates. However, for stage 1B tumors 5-year overall survival favored lobectomy.

Conclusion Lobectomy for stage 1 NSCLC in elderly patients is superior to sublobar resection in terms of survival and cancer recurrence and should be afforded where possible. For stage 1A tumors, sublobar resection is noninferior and may be considered. Further randomized controlled trials in this topic is required.

目的 我们对 1 期非小细胞肺癌 (NSCLC) 老年患者 (≥65) 的肺叶切除术与亚肺叶切除术的结果进行了系统评价和荟萃分析。

方法 我们使用一组纳入和排除标准搜索相关文章。应用了元分析技术。

结果选择了 12 项研究 ( n  = 5834)。我们的结果表明，在老年人中，1 期 NSCLC 的肺叶切除术比亚肺叶切除术具有生存优势。肺叶切除术患者 5 年内死亡的风险较低，局部癌症复发的几率较低。我们的研究结果表明，肺叶切除术具有更好的 5 年癌症特异性生存率和 5 年无病生存率，这趋于显着。亚肺叶切除组显示出更好的 30 天手术死亡率，趋于显着。1A 期癌症的亚组分析表明 5 年总生存率没有差异。然而，对于 1B 期肿瘤，5 年总生存期有利于肺叶切除术。

结论 老年患者 1 期 NSCLC 的肺叶切除术在生存率和癌症复发方面优于亚肺叶切除术，应尽可能给予。对于 1A 期肿瘤，亚肺叶切除是非劣效的，可以考虑。需要对该主题进行进一步的随机对照试验。