ArticleJournal of thoracic disease2025
Lobectomy versus sub-lobar resection for special type non-small cell lung cancer ≤2 cm.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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11 authors.
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Abstract
Background: Recent randomized trials have shown no significant difference in survival outcomes between lobectomy and sub-lobar resection for non-small cell lung cancer (NSCLC) ≤2 cm. However, these studies predominantly included common subtypes, such as adenocarcinoma and squamous cell carcinoma, with limited data on special type NSCLC (ST-NSCLC). This study aimed to address this gap by comparing overall survival (OS) outcomes between lobectomy and sub-lobar resection in patients with ST-NSCLC ≤2 cm. Methods: We analyzed Surveillance, Epidemiology, and End Results (SEER) database data (2000-2021) for clinical T1a-bN0M0 ST-NSCLC, including large cell carcinoma (LCC), large cell neuroendocrine carcinoma (LCNEC), adenosquamous carcinoma (ASC), malignant carcinoid (MC), and sarcomatoid carcinoma (SC). Patients undergoing lobectomy or sub-lobar resection were propensity score-matched to control baseline differences. OS was assessed using Kaplan-Meier methods and log-rank tests. Results: Of 6,517 patients (4,019 lobectomy, 2,498 sub-lobar resection), post-propensity score matching analysis showed lobectomy was associated with significantly better OS in LCC, LCNEC, ASC, and SC compared to sub-lobar resection. For MC, no OS difference was observed between approaches. In MC subgroup analysis, lobectomy was linked to longer OS in patients aged ≥60 years, white patients, and those without radiation or chemotherapy. Conclusions: In early-stage ST-NSCLC ≤2 cm, lobectomy is associated with better survival outcomes than sub-lobar resection for LCC, LCNEC, ASC, and SC, highlighting the role of tumor histology in surgical decisions. For MC, sub-lobar resection appears comparable to lobectomy. Prospective studies are needed to confirm these findings.
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