Radiofrequency identification-guided localization enables sublobar resection for small and early-stage lung cancer

Recent trials have expanded the role of sublobar resection for early-stage non-small cell lung cancer; however, accurate intraoperative localization remains challenging for small, ground-glass-dominant, or deeply located lesions. This study aimed to evaluate the clinical impact of a radiofrequency identification (RFID) marking system on recurrence outcomes following sublobar resection.

We retrospectively analyzed 297 patients with clinical N0 primary lung cancer who underwent sublobar resection (partial resection, n = 160; segmentectomy, n = 137). Patients were categorized according to RFID use. Clinicopathologic characteristics, surgical outcomes, and recurrence patterns were compared between groups. Cox proportional hazards models were used to identify factors associated with recurrence-free survival (RFS).

In the partial resection cohort, the RFID group showed a lower recurrence rate than the non-RFID group (3.4 vs. 22.2%, P < 0.001) with no local recurrences observed. However, after excluding adenocarcinoma in situ and minimally invasive adenocarcinoma to reduce selection bias, differences in recurrence were no longer significant. In the segmentectomy cohort, recurrence rates were comparable between groups (0 vs. 3.5%, P = 0.288), and no local recurrences occurred in the RFID group. On multivariable Cox analysis, consolidation-to-tumor ratio was the strongest predictor of RFS, whereas RFID use was not independently associated with improved RFS.

RFID marking was preferentially applied to small, ground-glass-dominant, and deeply located tumors, enabling sublobar resection for lesions that are difficult to localize intraoperatively.