Anatomic lung resections such as lobectomy and segmentectomy may be associated with improved long-term survival in patients with early-stage non–small cell lung cancer (NSCLC) compared with wedge resection, according to new findings presented at the 2025 Society of Thoracic Surgeons (STS) Annual Meeting.
Background
Cardiothoracic surgical practices are currently evolving rapidly, integrating innovative tools and approaches that prioritize patient safety and long-term health.
Study Methods and Results
In the study, investigators used data from the STS General Thoracic Surgery Database to analyze the outcomes of over 32,000 patients with stage IA NSCLC. The STS General Thoracic Surgery Database, part of the STS National Database, includes a majority of lung cancer and esophageal cancer surgeries performed in the United States and captures information on patient characteristics, surgical procedures, and outcomes. The investigators examined long-term follow-up information from the National Death Index and Centers for Medicare & Medicaid Services database, which provided up to 10 years of survival data.
Lobectomy offered the highest survival rates, with a 5- and 10-year overall survival of 71.9% and 44.8%, respectively. Segmentectomy, which resulted in a 5- and 10-year respective overall survival of 69.6% and 44.2% was found to be a viable alternative. Both lobectomy and segmentectomy demonstrated greater outcomes compared with wedge resection, which had 5-year overall survival of 66.3% and 10-year overall survival of 41.4%.
Conclusions
The research highlighted the benefit of using large-scale, real-world data to provide critical insights that complement findings from randomized controlled trials. While these trials suggested an equivalence between lobectomy and sublobar resections, the real-world analysis offered physicians additional insights to inform clinical practice, guide patient care, and provide a broader perspective applicable to diverse patient populations and health-care settings.
“This study reinforces the need for nuanced decision-making, integrating both [randomized controlled trials] and real-world data to deliver the highest quality of care. By analyzing outcomes in a variety of health-care settings, we can offer informed recommendations, ultimately improving patient outcomes across the board,” underscored Christopher Seder, MD, a thoracic surgeon at Rush University Medical Center. “This research is a significant step forward in understanding the long-term implications of surgical choices for [patients with] lung cancer. Using real-world data to complement [randomized controlled trial] findings offers surgeons additional context for tailoring treatment strategies,” he concluded.
Disclosure: For full disclosures of the study authors, visit sts2025.eventscribe.net.
