Long-Term Surgical Outcome of Lung Cancer in Africa: A Systematic Review and Meta-Analysis

BACKGROUND: Lung cancer is the leading cause of cancer death worldwide, with an estimated 1.8 million deaths in 2020. Despite the advancement of new treatment strategies that have emerged over time, surgery remains a very important aspect of cancer treatment. This study aims to highlight the long-term outcomes of surgery for lung cancer in Africa through a systematic review. METHODS: We conducted a systematic review using PRISMA guidelines over two databases: PubMed and Google Scholar. Inclusion criteria included studies that reported surgical outcomes of lung cancer in Africa until August 2024. The primary outcomes of interest were overall mortality, one and five-year survival rates, metastasis, morbidity, and recurrence. Data was analyzed using a random effect model for meta-analysis. RESULTS: Out of 381 articles, eight papers met our inclusion criteria. These articles described 2150 patients over five countries, including Egypt, Kenya, Tunisia, Nigeria, and Morocco. The meta-analysis of the reported outcomes produced an overall mortality rate of 27%, a one-year survival rate of 56%, a five-year survival rate of 13%, metastases of 77%, morbidity of 8%, and recurrence of 11%. CONCLUSION: The burden of lung cancer is high across Africa, which struggles with a lack of workforce and limited access to care. There is room for improvement in care by enhancing training and increasing access to care.