Background:Multiple primary lung cancer (MPLC) presents clinical challenges due to its biological complexity. While lobectomy remains standard, limited resection and localized ablation offer comparable efficacy. This systematic review evaluates the safety and efficacy of combining surgical and ablative therapies for MPLC.Methods:A comprehensive search of PubMed, Embase, and Web of Science (January 2000–2025) identified studies involving MPLC patients treated with both surgery and ablation, either concurrently or sequentially. Data on ablation efficacy, adverse events, and prognosis were extracted. A meta-analysis was performed when data pooling was appropriate. The methodological quality and risk of bias of the included studies were assessed using the MINORS and ROBINS-I tools. Publication bias was evaluated through funnel plots and Egger’s linear regression test. Furthermore, one case report on combination therapy was also included.Results:A total of nine studies met the inclusion criteria and were included in the final analysis. All reported a 100% technical success rate for ablation, efficacy rates exceeding 70%, and adverse event rates ranging from 5.0% to 26.7%. Due to significant heterogeneity among studies, a random-effects model was applied. The meta-analysis yielded a pooled ablation efficacy rate of 97.11% (95% CI: 85.81–100.00%) and a pooled adverse event rate of 14.23% (95% CI: 8.07–20.38%), indicating favorable safety and efficacy of the combined therapy.Conclusions:The integration of surgical and ablative therapies offers a safe and effective strategy for managing MPLC and supports a potential paradigm shift from single-modality treatment toward a more personalized, organ-preserving, and patient-centered approach.
背景：多原发性肺癌因其生物学复杂性给临床诊疗带来挑战。肺叶切除术虽仍是标准术式，但局限性切除与局部消融治疗已展现出相当的疗效。本系统综述旨在评估手术联合消融治疗多原发性肺癌的安全性与有效性。 方法：系统检索PubMed、Embase及Web of Science数据库（2000年1月至2025年），纳入同时或序贯接受手术与消融治疗的多原发性肺癌患者相关研究。提取消融疗效、不良事件及预后数据，在数据可合并时进行荟萃分析。采用MINORS及ROBINS-I工具评估纳入研究的方法学质量及偏倚风险，通过漏斗图与Egger线性回归检验评估发表偏倚。此外，本研究还纳入一例联合治疗病例报告。 结果：共九项研究符合纳入标准并进入最终分析。所有研究均报告消融技术成功率达100%，有效率超过70%，不良事件发生率介于5.0%至26.7%之间。由于研究间存在显著异质性，采用随机效应模型进行荟萃分析，结果显示合并消融有效率为97.11%（95% CI: 85.81–100.00%），合并不良事件发生率为14.23%（95% CI: 8.07–20.38%），表明联合治疗具有良好安全性及有效性。 结论：手术与消融治疗的整合为多原发性肺癌管理提供了安全有效的策略，支持从单一模式治疗向更个性化、器官保留及以患者为中心的诊疗模式转变。
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