SynthesisFrontiers in oncology2026
Lobectomy versus sublobar resection for stage I non-small cell lung cancer: an umbrella review of evidence quality, overlap, surgical-extent heterogeneity, and survival outcomes.
Synthesis in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
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Abstract
Background: Whether sublobectomy achieves survival outcomes comparable to lobectomy in Stage I non-small cell lung cancer (NSCLC) remains controversial. With increasing adoption of parenchymal-sparing surgery, a comprehensive evaluation of available evidence is warranted. Methods: A bibliometric analysis (2015-2025) was conducted alongside an umbrella review. PubMed, Embase, Web of Science, and CINAHL were searched for systematic reviews and meta-analyses comparing lobectomy and sublobectomy in Stage I NSCLC. Methodological quality was assessed using AMSTAR-2, and certainty of evidence was graded with GRADE. Summary hazard ratios (HRs) and heterogeneity were recalculated using random-effects models after removal of duplicate primary studies. Results: Eighteen reviews were included (9 high quality, 4 moderate, 5 critically low). Bibliometric analysis showed recent research bursts related to overall survival, disease-free survival, pulmonary segmentectomy, multicenter studies, and robotic-assisted thoracoscopic surgery. For overall survival (OS), pooled HRs varied and several analyses showed substantial heterogeneity (I² >70%). In recalculated pooled analyses, Stage I NSCLC showed an HR of 1.09 (95% CI 1.02-1.16; I² = 71.6%) and Stage IA an HR of 1.10 (95% CI 0.99-1.22; I² = 77.1%). For disease-free survival (DFS), HRs were 1.13 (95% CI 1.04-1.23; I² = 9.4%) for Stage I and 1.13 (95% CI 1.01-1.27; I² = 21.8%) for Stage IA. Evidence certainty was predominantly low or very low. Conclusion: Sublobar resection was associated with small but statistically significant higher hazards for OS and DFS in the broader Stage I population, whereas Stage IA OS did not differ significantly. However, OS estimates were limited by substantial heterogeneity, small-study effects, overlap among primary evidence, and predominantly low or very low certainty. This umbrella review clarifies the quality, bias, overlap, and applicability of existing meta-analytic evidence rather than replacing recent randomized trials. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251150573, identifier CRD420251150573.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.