Real world outcomes after lobectomy or sublobar resection for stage IA non-small cell lung cancer

Given the uncertain generalizability of recent clinical trial data, a comparative effectiveness analysis examining the long-term overall survival of real world patients may clarify the role of lobectomy and sublobar resection (segmentectomy or wedge resection) for early-stage non-small cell lung cancer. Retrospective analysis of the Society of Thoracic Surgeons General Thoracic Surgery Database (2012-2022) included 32,340 stage IA NSCLC (≤2 cm): 19,778 lobectomies; 4,279 segementectomies; and 8,283 wedge resections. In multivariable analysis, lobectomy was associated with improved overall survival and lung cancer-specific survival compared to sublobar resection. Both lobectomy and segmentectomy were associated with improved OS and LCSS compared to wedge resection. No significant differences in OS or LCSS were observed between lobectomy and segmentectomy. The authors conclude that in routine clinical practice, lobectomy and segmentectomy were associated with improved survival outcomes compared with wedge resection for stage IA NSCLC (≤2 cm) (graphical abstract).