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Table 3 The change of tumor cells in the effluent pulmonary veins after lobectomy (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 Change of CTCs after surgery in the effluent PV Indicators of tumor cells in PV HR (95% CI) of the sequence for CTCs
Wei [4] China Multicenter RCT (NCT03436329) 3 NSCLC: 38/40 I: 22/21; II: 10/10; III: 9/12; IV: 2/0, p > 0.05 Incremental changes of CTCs: 31.6% (12/38) vs. 65.0% (26/40), p < 0.05 NR 4.03 (1.53–10.63), p, 0.005
Kurusu [15] Japan Single-center RCT 4 NSCLC: 15/15
SCLC: 3/3
I: 14/15; IIIA: 4/3, p > 0.05 NR Positive CEA mRNA in initially negative samples: 42.9% (3/7) vs. 85.7% (6/7), p > 0.05 NR
Ge [16] China Single-center RCT 4 NSCLC: 12/11 I: 6/3; II: 3/4; III: 3/4, p > 0.05 NR Postoperative CEA mRNA was increased similarly, p > 0.05 NR
Ai [17] China Single-center RCT 4 NSCLC: 14/12 I: 3/3; II: 2/2; III: 9/7 NR The Pin 1 mRNA was changed similarly, p > 0.05 NR
Song [18] China Single-center RCT 4 NSCLC: 15/15 I/II/III: 9/13/8 NR Serum cytokeratin 19 (CK19)/adhesion molecule CD44v6 mRNA was changed significantly after surgery in artery-first group, but not vein-first group, p < 0.05 NR
Duan [1] China Retrospective 4 NSCLC: 19/14 I/II/III: 21/6/6 The increases of CTC after surgery was higher in the vein-first group (+ 11 vs. + 4.5), p < 0.05 NR NR
Hashimoto [19] Japan Retrospective 4 NSCLC: 9/21 I/II/III/IV: 17/8/3/2 The increase of CTCs after surgery was similar between the groups (+ 33 vs. + 56), p > 0.05 NR NR
  1. PV, pulmonary vein; CTCs, Circulating tumor cells; NSCLC, non-small cell lung cancer; SCLC, small cell lung cancer; Pin 1, peptidyl-prolyl cis–trans isomerase NIMA-interacting 1; NR, not reported
  2. *According to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence