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Table 1 The oncological results in the 7 included studies (vein-first versus artery-first)

From: Vein-first versus artery-first ligation procedure for lung cancer surgery: An updated review

References Country Study design Level of evidence* No. of patients Tumor staging Local recurrence Distant metastasis 5-year DFS 5-year OS HR (95% CI) of the sequence for survival Comments
Kozak [10] Poland Single-center RCT 2 170/215 I–III, p > 0.05 NR Total: 69 (17.9%) NR 92 (54%) vs. 108 (50%), p > 0.05 OS: 0.927 (0.708–1.214) (artery-first as reference)
Bai [11] China Single-center RCT 3 45/45 I: 39/38; II: 6/7, p > 0.05 3 (6.7%) vs. 2 (4.4%), p > 0.05 8 (17.8%) vs. 6 (13.3%), p > 0.05 29.5 months vs. 28.3 months, p > 0.05 NR OS: 0.154 (0.251–0.852) (artery-first as reference)
Refaely [12] Israel Retrospective 4 133/146 I: 77/75; II: 21/29; III: 29/39; IV: 6/3, p > 0.05 68 (51%) vs. 78 (53%), p > 0.05 NR NR NR Not significant
Li [13] China Retrospective 4 174/93 I: 138/79; II: 36/14, p > 0.05 6 (3.4%) vs. 2 (2.2%), p > 0.05 22 (12.6%) vs. 7 (7.5%), p > 0.05 Not significant Not significant Not significant
Sumitomo [5] Japan Retrospective 4 104/83 I: 91/70; II: 5/8; IIIA: 8/5, p > 0.05 4 (3.8%) vs. 6 (7.2%), p > 0.05 3 (2.9%) vs. 9 (10.8%), p < 0.05 92 (88.2%) vs. 63 (75.7%), p < 0.05 94 (90.9%) vs. 69 (82.7%), p > 0.05 DFS: 2.127 (1.009–4.481) (vein-first as reference) DFS of stage I (91 vs. 70), p < 0.05; DFS of stage II - IIIA (13 vs. 13), p > 0.05
He [14] China Retrospective 4 33/27 I: 14/10; II: 8/9; III: 10/8; IVA: 1/0, p > 0.05 NR NR 13 (39.40%) vs. 8 (29.6%), p > 0.05 22 (66.7%) vs. 12 (44.4%), p > 0.05 - OS/PFS of squamous type (10 vs. 8), p < 0.05
Wei [4] China Retrospective PSM 4 210/210 I–II NR NR 134 (63.6%) vs. 102 (48.4%), p < 0.05 155 (73.6%) vs. 121 (57.6%), p < 0.05 OS: 1.65 (1.07–2.56) (vein-first as reference) Vein-first better survival in stage I/ II
  1. RCT, randomized controlled trial; NSCLC, non-small cell lung cancer; SCLC, small cell lung cancer; PSM, propensity-score matched analysis; PV, pulmonary vein; OS, overall survival; DFS, disease-free survival; HR, Hazard ratio; CI, confidence interval; NR, not reported
  2. *According to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence