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  • br RESULTS br Quantity and Quality of Trials br Applying

    2020-03-17


    RESULTS
    Quantity and Quality of Trials
    Applying the predefined inclusion criteria, we identified a total of 2211 records through the electronic search. After identification of additional records through other sources and removal of duplicate studies, 1744 articles remained for screening. Of these, 1698 were excluded on the basis of title and abstract content. After review of the full text of the remaining 46 articles, 32 were found to meet the selection criteria for the systematic review.7,16-46 These included 1 retrospective pooled analysis of 2 randomized controlled trials and 31 observational studies, of which 24 provided data on propensity-matched populations. By selecting the most complete and updated studies from each institution or database, we identified 23 studies for quantitative meta-analysis. Quality assessment using the Newcastle-Ottawa Scale reported scores that ranged from 5 to 8 points, with a median of 6 points, indicating moderate quality overall. A summary of the study selection process is presented in the PRISMA chart in Figure E1, and a summary of each study, with detailed characteristics, is presented in Table 1. 
    THOR
    The Journal of Thoracic and Cardiovascular Surgery c Volume 157, Number 1 363
    Thoracic: Lung Cancer: Review Cao et al
    THOR
    TABLE 1. Summary of studies comparing overall survival outcomes between stereotactic body MIK665 (S-64315) therapy and surgical resection for patients with non–small cell lung cancer
    N
    Institution Author Study period SBRT Surgery
    Mortality Morbidity OS DFS CSS REC USA
    C
    C
    B
    C B
    B
    B
    C
    C
    B
    B
    B
    C
    C
    C
    C
    C C B
    B
    C
    C
    C
    Infrastructure
    B
    B B
    B
    C C C
    C C
    C C C
    B
    B B
    C C
    B
    C C C
    C C
    (Continued)
    364 The Journal of Thoracic and Cardiovascular Surgery c January 2019
    Cao et al Thoracic: Lung Cancer: Review
    TABLE 1. Continued
    N
    Institution Author Study period SBRT Surgery Mortality Morbidity OS DFS CSS REC Netherlands
    C C
    C
    C
    C C
    C B
    C C C C
    B
    B
    B Others
    THOR
    Dots denote presented data. Solid dots denote data selected for quantitative analysis. Asterisks indicate matching of patients by propensity score analysis or retrospective pooling of randomized data. OS, Overall survival; DFS, disease-free survival; CSS, cancer-specific survival; REC, locoregional or distant recurrence; SBRT, stereotactic body radiation therapy; SEER, Surveillance, Epidemiology, and End Results; S, sublobar resection; L, lobectomy; NCDB, National Cancer Database; VA, Veterans Affairs; W, wedge; VAMC, Veterans Affairs Medical Center; VU, Vrije Universiteit; PLA, People’s Liberation Army.
    Propensity Score Matching
    The systematic review identified 24 studies that used propensity score matching by statistically balancing a number of covariables, which can be categorized into patient characteristics, preoperative risk factors, and tumor characteristics. The most commonly used factors included age; gender; Charlson comorbidity index; performance status; pulmonary function test; size, stage, location, and histologic profile of the tumor; and the preprocedural use of positron emission tomography. A summary of all the chosen covariates for propensity-matched studies selected for meta-analysis is presented in Table 2. When individual studies used more than 1 caliper for comparison between treatment groups, data were derived from the most detailed comparison.
    Patient Characteristics
    A summary of baseline characteristics of matched patients selected for meta-analysis, including age, gender, SBRT regimen, and surgical procedure details, is presented in Table 3. A summary of these details for unmatched patients is presented in Table E1. In brief, the interquartile range of ages for matched patients was 71 to 78 years for