Survival Improved With Lobectomy, Segmentectomy in Early NSCLC

TUESDAY, Jan. 28, 2025 (HealthDay News) — For patients with stage IA non-small cell lung cancer (NSCLC), lung resections, including lobectomy and segmentectomy, are associated with improved long-term survival compared with wedge resection, according to a study presented at the annual meeting of The Society of Thoracic Surgeons, held from Jan. 24 to 26 in Los Angeles.

Christopher Seder, M.D., from the Rush University Medical Center in Chicago, and colleagues analyzed data from 32,340 patients undergoing lung resection surgery for stage IA NSCLC from 346 U.S. institutions: 61.2, 13.2, and 25.6 percent underwent lobectomy, segmentectomy, and wedge resection, respectively.

The researchers found that lobectomy was associated with improved survival compared with sublobar resection (hazard ratio for overall survival [OS] and lung-cancer specific survival [LCSS], 0.87 and 0.91, respectively), specifically compared with wedge resection (hazard ratios, 0.84 and 0.88 for OS and LCSS, respectively), but not segmentectomy. Compared with wedge resection, segmentectomy was associated with improved survival (hazard ratios, 0.88 and 0.91 for OS and LCSS, respectively). In a sensitivity analysis excluding pathologic-upstaged cases, similar improved survival was seen for lobectomy versus sublobar and wedge resection; lobectomy survival was improved versus segmentectomy (hazard ratios, 0.88 and 0.89 for OS and LCSS, respectively), and survival was similar for segmentectomy and wedge resection.

“This research is a significant step forward in understanding the long-term implications of surgical choices for lung cancer patients,” Seder said in a statement. “Using real-world data to complement randomized controlled trial findings offers surgeons additional context for tailoring treatment strategies.”

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