A Meta Analysis Of Surgery Treatment For Small Cell Lung Cancer

Objectives Combination chemotherapy remains the mainstay of treatment for both limited-stage and extensive-stage SCLC. The aim of this retrospective study was to analyze the role of surgery in the management of stage Ⅰ、Ⅱ、Ⅲ small cell lung cancer. Hope this article can offer reference for the treatment and indications surgery of small cell lung cancer. Methods Searching WanFang Data, CNKI, PubMed, The Cochrane Library to find out studies about the role of surgery in the management of small cell lung cancer. According to the requisition of systematic evaluation, we formulate detailed standardization of the inclusion and exclusion criteria. The statistical analysis were performed using Review Manager version5.0(Cochrane Collaboration, Oxford, UK) and CMA 3(Comprehensive Meta Analysis 3).Results Ten studies were enrolled, nine of them were cohort studies, and the other is a non-randomized experimental study. The lyear and 5 year survival rates after surgical treatment for patients with stage I SCLC are higher than non-surgical treatment group. The RR are RR=1.85,95% CI [1.60,2.13],P< 0.00001 and RR=2.51,95% CI [1.91,3.30],P <0.00001, respectively. The test of heterogeneity showed that there was statistical heterogeneity among 5 year survival rate studies included in the Meta-analysis. The 3year and 5 year survival rates after surgical treatment for patients with stage II SCLC are higher than non-surgical treatment group. The RR are RR=1.29,95% CI [1.05,1.58],P= 0.02 and RR=1.94,95% CI [1.38,2.27],P= 0.0001, respectively. The test of heterogeneity showed that the heterogeneity among studies included in the Meta-analysis would be accepted. Meta-analysis demonstrated that the combined RR of these studies about patients with stage III SCLC shows no statistically significant difference, The RR are RR=1.17,95% CI [0.89,1.53] and RR=1.35,95% CI [0.88,2.08], respectively. Conclusion In the patients with stage I and stage II SCLC, The prognosis of surgical treatment group is better compared with non-surgical treatment. There is no statistically significant difference between the surgical treatment group and non-surgical treatment group with stage III SCLC.