Masatsugu Hamaji, MD, Syed Osman Ali, MD, Bryan M. Burt, MD

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A Meta-Analysis of Resected Metachronous Second Non-Small Cell Lung Cancer Masatsugu Hamaji, MD, Syed Osman Ali, MD, Bryan M. Burt, MD The Annals of Thoracic Surgery Volume 99, Issue 4, Pages 1470-1478 (April 2015) DOI: 10.1016/j.athoracsur.2014.11.033 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 The flow of selecting studies papers following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The Annals of Thoracic Surgery 2015 99, 1470-1478DOI: (10.1016/j.athoracsur.2014.11.033) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Pooled (A) operative mortality and (B) morbidity rates after resection of metachronous second primary non-small cell lung cancer (NSCLC). (C) Pooled 5-year overall survival (OS) rate after resection of metachronous second primary NSCLC. (D) Pooled 5-year OS rate after resection of first NSCLC. (E) Pooled 5-year OS rate after resection of stage Ia metachronous second primary NSCLC. The left portions of the figures show the studies analyzed, with their corresponding rates, lower and upper limits, z values, and p values. The right portions of the figures show a forest plot of the data. The squares symbolize the mortality rate, morbidity rate, or OS rate for each study. The larger the square, the more weight it contributes to the results of the meta-analysis. The horizontal lines represent the values within the 95% confidence interval (CI) of the underlying effects. (SE = standard error.) The Annals of Thoracic Surgery 2015 99, 1470-1478DOI: (10.1016/j.athoracsur.2014.11.033) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Pooled 5-year overall survival (OS) differences in comparison with 5-year OS rates (A) in patients with lobar resection and patients with sublobar resection; (B) in patients with the same histology as first non-small cell lung cancer (NSCLC) and patients with different histology from first NSCLC; and (C) in patients with the interval from first NSCLC less than 2 years and patients with the interval from first NSCLC 2 years or more, with meta-analysis using a random effects model. The left portions of the figures show the studies analyzed with their corresponding rates or risk differences, lower and upper limits, z values, and p values. The right portions of the figures show a forest plot of the data. The squares symbolize the risk difference for each study. The larger the square, the more weight it contributes to the results of the meta-analysis. The horizontal lines represent the values within the 95% confidence interval (CI) of the underlying effects. The vertical line indicates a risk difference of 0. (SE = standard error.) The Annals of Thoracic Surgery 2015 99, 1470-1478DOI: (10.1016/j.athoracsur.2014.11.033) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Funnel plots of precision by log standard error (SE) showed that all the studies fall symmetrically, suggesting a lack of important publication bias, in comparisons of 5-year overall survival rates (A) in patients with lobar resection and patients with sublobar resection; (B) in patients with the same histology as first non-small cell lung cancer (NSCLC) and patients with different histology from first NSCLC; and (C) in patients with the interval from first NSCLC less than 2 years and patients with the interval from first NSCLC 2 years or more. (RD = risk difference.) The Annals of Thoracic Surgery 2015 99, 1470-1478DOI: (10.1016/j.athoracsur.2014.11.033) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions