Meta-analysis Of The Clinical Efficacy Of Systematic Versus Nonsystematic Lymph Node Dissection For Early Non-small Cell Lung Cancer

Objective: Currently,surgical resection of tumor tissue and lymph node dissection have become the main treatment methods for lung cancer,but there are still great controversies about whether lymph node dissection should be performed for early non-small cell lung cancer(NSCLC)and what kind of lymph node dissection should be used.Therefore,systematic lymph node dissection(SLND)and non-systematic lymph node dissection(NSLND)were compared in the clinical safety,efficacy and long-term prognosis of patients withearly NSCLC.Methods : By searching literatures related to the safety and efficacy of systematic and non-systematic lymph node dissection in the treatment of early NSCLC in cn KI,VIP,Wanfang,Pubmed,PMC,Google Academic and other databases,literature screening,quality evaluation and data extraction were conducted.Statistical methods were used to Meta analyze the extracted data and draw forest maps.Results:A total of 1337 relevant literatures were collected through computer retrieval,including 11 literatures,including 4literatures in Chinese and 7 literatures in English.A total of 2331 patients were included in the study sample,including 1512 patients in the systematic lymph node dissection group and 819 patients in the non-systematic lymph node dissection group.Meta-analysis results show that: Comparison of outcome indicators related to systematic and non-systematic lymph node dissection showed that operative time(SMD=0.51,95%CI = [0.22,0.79],P=0.0005),intraoperative bleeding(SMD=0.24,95%CI = [0.14,0.35],P<0.00001),time of chest tube implantation(MD=0.45,95%CI = [0.16,0.75],P=0.002),five-year survival rate(OR=1.54,95%CI = [1.16,2.04],P=0.002),indicating statistical significance.There was no significant difference between SLND and NSLND in length of hospital stay(MD=0.77,95%CI = [-0.61,2.15],P=0.27)and postoperative complications(OR=1.21,95%CI = [0.61,2.24],P=0.59).Conclusions: Patients with unsystematic lymph node dissection have a higher five-year postoperative survival rate,suggesting that systematic lymph node dissection may be superior to systematic lymph node dissection in the long-term prognosis of patients with early NSCLC.Non-systematic lymph node dissection can be used for early NSCLC surgery,but large-scale prospective trials are still needed to further verify the results.