Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonology

Background:

• Early detection of small non-small cell lung cancers (NSCLC) is increasing.
• Lobar resection remains the standard treatment, despite advancements in early detection.

Purpose of the Study:

• To compare sublobar resection (segmentectomy or wedge resection) with lobar resection for early-stage NSCLC.
• To determine the appropriate surgical procedure for small lung lesions.

Main Methods:

• A nonrandomized study compared 305 patients undergoing sublobar resection with 262 patients undergoing lobar resection.
• Patients had peripheral cT1N0M0 NSCLC ≤ 2 cm and were candidates for lobectomy.

Main Results:

• No significant differences in patient characteristics, curability, pathologic stage, morbidity, or recurrence rates were observed.
• 5-year disease-free and overall survival rates were similar between sublobar and lobar resection groups (approx. 85-90%).
• Sublobar resection resulted in significantly better postoperative lung function.

Conclusions:

• Sublobar resection is a suitable alternative for stage IA NSCLC ≤ 2 cm, even in low-risk patients.
• These findings support further randomized trials to potentially change surgical standards for early-stage NSCLC.
• Improved lung function post-sublobar resection warrants its consideration in surgical decision-making.