STS Expert Consensus Document (2026) on Addressing Definition and Practices of Sublobar Resection in Non-small Cell...

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Recent trials indicate sublobar resection is non-inferior to lobectomy for early-stage, node-negative non-small cell lung cancer (NSCLC) ≤ 2cm.
• This has led to increased utilization of sublobar resection for early lung cancer.
• Need for consensus recommendations to guide appropriate sublobar resection use.

Purpose of the Study:

• To develop consensus recommendations for the appropriate utilization of sublobar resection in early-stage lung cancer.
• To address key areas of controversy regarding sublobar resection versus lobectomy.

Main Methods:

• A panel of thoracic surgeons with clinical and methodological expertise was convened.
• A modified Delphi method was employed to reach consensus.
• Agreement was defined as >75% consensus on statements after a priori determined parameters.

Main Results:

• Seven key areas of controversy were identified.
• Three rounds of voting were conducted.
• Twenty-one statements were agreed upon by >75% of the panel to guide sublobar resection use.

Conclusions:

• Key questions persist regarding sublobar resection for early-stage NSCLC despite recent trial data.
• The developed statements offer guidance for clinicians making surgical decisions.
• These recommendations aim to optimize the use of sublobar resection in appropriate patients.