ReviewFrontiers in oncology2026
CALGB 140503 and the shift to sublobar resection for small, peripheral, node-negative NSCLC: historical context, secondary analyses, and next steps.
Review in Frontiers in oncology, 2026. 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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Abstract
The surgical management of early-stage non-small cell lung cancer (NSCLC) has been reshaped by contemporary randomized data supporting lung-sparing approaches in carefully selected patients. CALGB/Alliance 140503, a multicenter phase III trial, compared sublobar resection (wedge or segmentectomy) with lobectomy for peripheral, clinically node-negative NSCLC ≤2 cm, randomizing patients only after rigorous intraoperative nodal assessment. Sublobar resection proved noninferior to lobectomy with respect to disease-free survival, with comparable overall survival and recurrence patterns. Alongside other important randomized trials like JCOG 0802/WJOG 4607L, sublobar resection has now been established as an acceptable - and for some patients preferable - strategy for stage IA (≤ 2 cm) NSCLC. Beyond its primary results, CALGB 140503 has generated a series of secondary and exploratory analyses that continue to refine day-to-day clinical decision-making. This mini-review aims to synthesize the current state of insights from this trial, highlighting ongoing controversies and key gaps for future investigation that will further optimize the management of early-stage NSCLC.
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