ArticleThe Journal of thoracic and cardiovascular surgery2026
Lobectomy improves disease-free survival over sublobar resection for high-risk stage IA non-small cell lung cancer.
Article in The Journal of thoracic and cardiovascular surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Segmentectomy vs Lobectomy for Peripheral Early-Stage Non-Small Cell Lung Cancer in Patients With Radiologically High Risk Tumors.Annals of thoracic surgery short reports · 2026Article
- Sublobar Resection in Stage I Non-Small Cell Lung Cancer With Lymphovascular Invasion.Annals of thoracic surgery short reports · 2026Article
- Prognostic stratification of T1 lung adenocarcinoma with micropapillary or solid patterns: a cohort study.Journal of thoracic disease · 2026Article
- Article
- Novel insights into predicting the presence of micropapillary and solid components in stage IA lung adenocarcinoma using machine learning models of modifiable risk factors.Annals of medicine · 2025Article
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18 authors.
Funding
Abstract
objectiveTo investigate disease-free survival (DFS) of sublobar resection versus lobectomy for stage IA non-small cell lung cancer (NSCLC) with preoperative high-risk features.
methodsData were abstracted from a prospective database to identify patients with clinical T1a-T1bN0M0 NSCLC (≤2 cm) who underwent lobectomy or sublobar resection (wedge resection or segmentectomy). 1:1 propensity matching was used to balance the dataset for forced expiratory volume in 1 second ≥60% and high-risk features: cT1b versus cT1a, standard uptake value of the primary tumor on positron emission tomography, solid versus subsolid tumor texture on computed tomography, and micropapillary/solid histology. The primary outcome was DFS.
resultsIn total, 825 patients met inclusion criteria: 52% (n = 426) patients underwent lobectomy and 48% (n = 399) of patients underwent sublobar resection (45% segmentectomy, 55% wedge resection). Lobectomy was associated with more preoperative high-risk features: cT1b (P < .001), greater standard uptake value (P < .001), solid tumor texture on computed tomography (P < .001), and micropapillary/solid histology (P < .001). In total, 660 patients were included in the matched analysis with all high-risk features balanced. Nodal upstaging (N1) was greater in patients who underwent lobectomy (9.1% vs 3.4%, P = .004). Five-year DFS (85% vs 74%, P = .12) was equivalent in the matched cohort. Lobectomy was protective for recurrence in the presence of 2 or greater high-risk features: sublobar resection patients with 2 high-risk features (hazard ratio, 1.77; 95% confidence interval, 1.13-2.76, P = .012) or 3-4 high-risk features (hazard ratio, 1.97; 95% confidence interval, 1.25-3.10, P = .004) had worse DFS.
conclusionsLobectomy should be considered over sublobar resection for stage IA NSCLC ≤2 cm in the presence of multiple high-risk features.
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