The lesser the better? A systematic review and meta‐analysis of resection strategy in lung neuroendocrine tumors

INTRODUCTION: Lung neuroendocrine tumors (LNETs) are rare, with surgical resection as the mainstay of treatment, although the optimal extent remains uncertain. Herein, we present the first meta-analysis to assess the effect of resection extent (lobar vs. sub-lobar) on overall survival. METHODS: We conducted a systematic review of the literature to identify studies comparing overall survival following lobectomy versus sub-lobar resection in LNETs. An inverse-variance meta-analysis was performed, and a Cox regression model was applied to reconstructed time-to-event data estimated from published Kaplan-Meier curves to generate pooled survival estimates. RESULTS: = 0%). Sampling of >10 lymph nodes was more frequent in lobectomy than sub-lobar resection (29.1% [95% CI, 0.8-95.3] vs 7.4% [95% CI, 0.01-98], respectively), likely contributing to the higher rate of nodal pathologic upstaging observed in the lobectomy group (6.2% [95% CI, 0.2-64.9] vs 2.2% [95% CI, 0-99]). CONCLUSION: In this first meta-analysis of surgical resection for LNETs, sub-lobar resection and lobectomy showed no clear difference in overall survival. Adequate lymph node assessment remains essential, irrespective of the surgical approach.