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The impact of surgeon experience on lung cancer operations: A retrospective propensity-matched cohort study

  • 0Medical Research Center, University of Oulu and Oulu University Hospital, Aapistie 5A, 90220 Oulu, Finland.
Scandinavian Journal of Surgery : Sjs : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society +

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September 16, 2025

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September 16, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Surgical outcomes for primary non-small cell lung cancer were comparable between resident and specialist surgeons. This study found no significant differences in complication rates or survival, supporting resident-led anatomical resections.

Area Of Science

  • Thoracic Surgery
  • Surgical Oncology
  • Medical Education

Background

  • Anatomical resection is a standard surgical approach for primary non-small cell lung cancer (NSCLC).
  • Evaluating the impact of surgeon experience on clinical and oncological outcomes is crucial for patient safety and quality of care.

Purpose Of The Study

  • To compare the clinical and oncological outcomes of anatomical lung cancer resections performed by resident surgeons versus specialist surgeons.
  • To assess complication rates and survival data in a medium-volume hospital setting.

Main Methods

  • Retrospective analysis of 959 primary NSCLC surgical resections performed between 2000 and 2020.
  • Propensity score matching (1:2 ratio) to compare 65 resident-led cases with 130 specialist-led cases.
  • Evaluation of intra-operative and post-operative complications (Clavien-Dindo classification) and survival rates (overall and disease-specific).

Main Results

  • No significant difference in intra-operative complication rates (12.3% vs. 8.5%) or major Clavien-Dindo complications (>IIIa) (12.3% vs. 15.4%) between resident-led and specialist-led surgeries.
  • Comparable 1, 3, and 5-year overall survival rates (p=0.389) and disease-specific survival rates (p=0.931) between the two groups.
  • Kaplan-Meier analysis indicated similar long-term oncological results regardless of lead surgeon expertise.

Conclusions

  • Surgeon expertise (resident vs. specialist) did not significantly impact intra-operative or post-operative complication rates in anatomical lung cancer resections.
  • Both short-term clinical outcomes and long-term oncological results were comparable between resident-led and specialist-led surgeries.
  • These findings suggest that resident-led anatomical resections can achieve outcomes similar to those performed by specialists.

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