SynthesisInternational journal of surgery (London, England)2025
Could less be enough: sublobar resection vs lobectomy for clinical stage IA non-small cell lung cancer patients with visceral pleural invasion or spread through air spaces.
Synthesis in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Ensemble machine learning classifiers based on computed tomography radiomics for predicting spread through air spaces in lung adenocarcinoma: a multicenter retrospective cohort study with transcriptomic interpretation.Quantitative imaging in medicine and surgery · 2026Article
- CT-based Prediction of Visceral Pleural Invasion in Lung Adenocarcinoma ≤ 3 cm: Enhancing Deep Learning Specificity by Waiving Chest Wall Information.Annals of surgical oncology · 2026Article
- Article
- Current real-life survival after segmentectomy for lung cancer.Frontiers in surgery · 2026Article
- Nomogram based on computed tomography fractal dimension for predicting spread through air spaces in lung adenocarcinoma.Frontiers in medicine · 2026Article
- Tumoral and Peritumoral Radiomics for Preoperative Prediction of Visceral Pleural Invasion in Lung Adenocarcinoma.Cancers · 2025Article
- Artificial Intelligence as a Diagnostic Tool in Preoperative Surgical Planning for Early Non-Small Cell Lung Cancer: A Single-Center Experience.Journal of clinical medicine · 2025Article
- Visible Pleural Retraction is a Prognostic Marker in Early-Stage Non-Small Cell Lung Cancer: A Retrospective Cohort Study.Annals of surgical oncology · 2025Article
- Article
- Development and validation of machine learning models for predicting STAS in stage I lung adenocarcinoma with part-solid and solid nodules: a two-center study.Frontiers in oncology · 2025Article
- Prognostic significance of visceral pleural changes in stage IA lung adenocarcinoma: a retrospective study.Frontiers in oncology · 2025Article
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5 authors.
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Abstract
backgroundWhile recent randomized controlled trials have demonstrated that sublobar resection (SLR) is non-inferior to lobectomy, the comparative efficacy of these procedures remains uncertain for early-stage non-small cell lung cancer (NSCLC; ≤3 cm) exhibiting invasive features postoperatively, such as visceral pleural invasion (VPI) or spread through air spaces (STAS). MATERIALS AND
methodsTo identify eligible studies, a comprehensive search of PubMed, Embase, MEDLINE, the Cochrane Library, and Web of Science was conducted through 25 July 2024. Studies were screened according to predefined criteria in accordance with PRISMA guidelines. The primary endpoints were 5-year overall survival (OS) and recurrence-free survival (RFS). Hazard ratios (HR) and 95% confidence intervals (CI) were used to perform a meta-analysis.
resultsThe final analysis included 14 retrospective studies and 1 randomized controlled trial, encompassing a total of 8054 patients with NSCLC (tumors ≤3 cm) exhibiting VPI or STAS. The meta-analysis revealed that SLR was associated with impaired 5-year OS (HR: 1.25; 95% CI: 1.10-1.41) and slightly inferior RFS (HR: 1.25; 95% CI: 0.99-1.58) compared to lobectomy for pT2a (VPI) NSCLC patients with tumor ≤3 cm. Similarly, SLR was associated with significantly worse 5-year OS (HR: 2.58; 95% CI: 1.92-3.45) and 5-year RFS (HR: 2.42; 95% CI: 1.69-3.46) compared to lobectomy for stage IA NSCLC patients with STAS. Subgroup analysis revealed that statistically significant differences in 5-year OS (HR: 1.13; 95% CI: 0.92-1.38) and 5-year RFS (HR: 0.87; 95% CI: 0.56-1.36) were not observed between the SLR and lobectomy groups for pT2a (VPI) NSCLC patients with tumor ≤2 cm. Additionally, no statistically significant survival difference was observed between the segmentectomy and lobectomy groups for NSCLC patients (≤3 cm) with VPI (5-year OS: HR: 1.16; 95% CI: 0.89-1.52; 5-year RFS: HR: 1.07; 95% CI: 0.88-1.30) or STAS (5-year OS: HR: 3.88; 95% CI: 0.82-18.31; 5-year RFS: HR: 1.64; 95% CI: 0.70-3.80).
conclusionsFor early-stage (≤3 cm) NSCLC with VPI or STAS, SLR was associated with worse survival outcomes compared to lobectomy. However, segmentectomy achieved survival outcomes comparable to those of lobectomy. For pT2a (VPI) NSCLC patients with tumor ≤2 cm, the differences in survival outcomes between SLR and lobectomy were not statistically significant.
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