ArticleTranslational lung cancer research2021
Surgery for advanced-stage non-small cell lung cancer: lobectomy or sub-lobar resection?
Article in Translational lung cancer research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 13 citations in OpenAlex.
- A prognostic nomogram for oligometastatic non-small cell lung cancer incorporating extent of primary tumor resection as a key predictor.Journal of thoracic disease · 2026Article
- Outcomes After Neoadjuvant Targeted Therapy in Patients with ALK or ROS1 Rearrangement Locally Advanced Non-small Cell Lung Cancer.Annals of surgical oncology · 2025Article
- ASO Author Reflections: Neoadjuvant Targeted Therapy in Locally Advanced Non-small Cell Lung Cancer.Annals of surgical oncology · 2025Article
- The Prognostic Impact of Lymph Node Dissection on Primary Tumor Resection for Stage IV Non-Small Cell Lung Cancer: A Population-Based Study.Frontiers in oncology · 2022Article
- Stage IV non-small cell lung cancer among young individuals: Incidence, presentations, and survival outcomes of conventional therapies.Frontiers in oncology · 2022Article
- Exploring the Role of Preoperative Systemic Therapy and Primary Resection in NSCLC With Extrathoracic Metastases: Identifying the Optimal Candidates.Cancer control : journal of the Moffitt Cancer CenterArticle
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21 authors at 8 institutions in 4 countries.
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Abstract
backgroundMetastatic non-small cell lung cancer (NSCLC) has many comorbidities, such as chronic obstructive pulmonary disease, coronary heart disease, and older age-related comorbidities. A survival benefit was observed in such patients who underwent surgery for selected oligometastatic disease. However, to the best of our knowledge, there is no evidence to support whether lobectomy (compared with sub-lobar resection) would further prolong these patients' lives.
methodsPatients with metastatic NSCLC who underwent primary tumor resection were identified from the Surveillance, Epidemiology, and End Results (SEER) database and then divided into lobectomy and sub-lobar resection groups. Propensity score matching (PSM, 1:1) was performed to match the baseline characteristics of the two groups. Cancer-specific survival (CSS) was estimated.
resultsIn total, 24,268 patients with metastatic NSCLC were identified; 4,114 (16.95%) underwent primary tumor surgery, and of these, 2,045 (49.71%) underwent lobectomy and 1,766 (42.93%) underwent sub-lobar resection. After PSM, 644 patients in each group were included. Lobectomy was independently correlated with longer median CSS time [hazards ratio (HR): 0.70, 95% confidence interval (CI): 0.61-0.80, P<0.001]. The 1, 2, and 3-year survival rates after PSM also favored the lobectomy group. However, no significant survival difference was found for wedge resection and segmentectomy (HR: 0.96, 95% CI: 0.70-1.31, P=0.490). The 1-, 2-, and 3-year survival rates after PSM also exhibited no difference within the sub-lobar group. We explored whether lymph node dissection would provide additional survival benefits for stage IV NSCLC patients. According to the multivariate Cox analysis of the matched population, lymph node dissection was independently associated with better CSS (HR: 0.76, 95% CI: 0.66-0.88, P<0.001) and overall survival (OS) (HR: 0.74, 95% CI: 0.65-0.86, P<0.001). We confirmed this result in the different types of surgery and found that the lymph node dissection group consistently had better survival outcomes both in the lobectomy group and sub-lobar resection population. According to the subgroup analysis, with the exception of stage T4 and brain metastatic patients, all of the patient subtypes exhibited greater benefit from lobectomy than sub-lobar resection.
conclusionsLobectomy has a greater survival benefit in metastatic NSCLC patients compared with sub-lobar resection when radical treatment of primary site was indicated.
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