Akamine T, Wakasu S, Matsubara T, Yamaguchi M, Yamazaki K, Hamatake M, Kometani T, Kinoshita F, Kohno M, Shimokawa M, Takenaka T, Yoshizumi T. Is Sublobar Resection Feasible for High-Risk Pathologic Stage I Non-small Cell Lung Cancer? Ann Surg Oncol. 2025 Jun;32(6):4161-4172. doi: 10.1245/s10434-024-16700-z. Epub 2024 Dec 16. PMID: 39681715.
- Sublobar resection is feasible for low-risk pathologic stage I NSCLC, whereas lobectomy may have a prognostic benefit for high-risk NSCLC.
- High-risk pathologic feature was defined as evidence of pleural invasion, lymphovascular invasion, or invasive component (>2 cm).
Merritt RE, Brunelli A, Walsh G, Murthy S, Schuchert MJ, Varghese TK, Lanuti M, Wolf A, Keshavarz H, Loo BW, Suh RD, Mak RH, Criner GJ, Mazzone PJ, Liptay M, Wafford QE, Marshall MB, Tong B, Pettiford B, Rocco G, Luketich J, D'Amico TA, Swanson SJ, Pennathur A; AATS Clinical Practice Standards Committee: Thoracic Surgery. Systematic Review of Sublobar Resection for Treatment of High-Risk Patients with Stage I Non-Small Cell Lung Cancer. Semin Thorac Cardiovasc Surg. 2025 Spring;37(1):99-105. doi: 10.1053/j.semtcvs.2024.11.002. Epub 2024 Dec 12. PMID: 39674442.
Tasoudis P, Loufopoulos G, Manaki V, Doerr M, Agala CB, Long JM, Haithcock BE. Long term outcomes after lobar versus sublobar resection for patients with Non-Small cell lung Cancer: Systematic review and individual patient data Meta-Analysis. Lung Cancer. 2024 Sep;195:107929. doi: 10.1016/j.lungcan.2024.107929. Epub 2024 Aug 16. PMID: 39173232.
- Lobectomy is associated with better overall survival compared to sublobar resection in NSCLC patients. However, when sublobar resection is subdivided, segmentectomy shows comparable outcomes to lobectomy, while wedge resection is inferior.
Bertolaccini L, Tralongo AC, Del Re M, Facchinetti F, Ferrara R, Franchina T, Graziano P, Malapelle U, Menis J, Passaro A, Pilotto S, Ramella S, Rossi G, Trisolini R, Cinquini M, Passiglia F, Novello S. Segmentectomy vs. Lobectomy in stage IA non-small cell lung cancer: A systematic review and meta-analysis of perioperative and survival outcomes. Lung Cancer. 2024 Nov;197:107990. doi: 10.1016/j.lungcan.2024.107990. Epub 2024 Oct 21. PMID: 39461280.
Lee JM. Sublobar Resection vs Lobectomy for High-Risk Stage I Non-Small Cell Lung Carcinoma. JAMA Oncol. 2024 Sep 1;10(9):1173-1175. doi: 10.1001/jamaoncol.2024.2294. PMID: 39088204.
Kneuertz PJ, Ferrari-Light D, Altorki NK. Sublobar Resection vs Lobectomy for Stage IA Non-Small Cell Lung Carcinoma-Takeaways From Modern Randomized Trials. Ann Thorac Surg. 2024 May;117(5):897-903. doi: 10.1016/j.athoracsur.2023.12.008. Epub 2024 Jan 5. PMID: 38184163.
Mathey-Andrews C, Abruzzo AR, Venkateswaran S, Potter AL, Senthil P, Beqari J, Yang CJ, Lanuti M. Segmentectomy vs Lobectomy for Early Non-Small Cell Lung Cancer With Visceral Pleural Invasion. Ann Thorac Surg. 2024 May;117(5):1007-1014. doi: 10.1016/j.athoracsur.2023.06.020. Epub 2023 Jul 5. PMID: 37419171.
- NCDB. visceral pleural invasion (VPI). no differences were found in survival or in short-term outcomes between patients undergoing segmentectomy vs lobectomy for early-stage NSCLC with VPI. Our findings suggest that if VPI is detected after segmentectomy for cT1a-bN0M0 tumors, completion lobectomy is unlikely to confer an additional survival advantage.
Li T, He W, Zhang X, Zhou Y, Wang D, Huang S, Li X, Fu Y. Survival outcomes of segmentectomy and lobectomy for early stage non-small cell lung cancer: a systematic review and meta-analysis. J Cardiothorac Surg. 2024 Jun 22;19(1):353. doi: 10.1186/s13019-024-02832-6. PMID: 38909240; PMCID: PMC11193294.
- survival outcomes of the segmentectomy group were not inferior to that of the lobectomy group
Lu G, Xiang Z, Zhou Y, Dai S, Tong F, Jiang R, Dai M, Zhang Q, Zhang D. Comparison of lobectomy and sublobar resection for stage I non-small cell lung cancer: a meta-analysis based on randomized controlled trials. Front Oncol. 2023 Oct 4;13:1261263. doi: 10.3389/fonc.2023.1261263. PMID: 37860201; PMCID: PMC10582352.
- lobectomy is usually not a justified operation
Meldola PF, Toth OAS, Schnorrenberger E, Machado PG, Chiarelli GFC, Kracik JLS, de Carvalho CC, Lôbo MM, Gross JL. Sublobar resection versus lobectomy for stage IA non-small-cell lung cancer: A systematic review and meta-analysis of randomized controlled trials. Surg Oncol. 2023 Dec;51:101995. doi: 10.1016/j.suronc.2023.101995. Epub 2023 Sep 22. PMID: 37776757.
Fong KY, Chan YH, Chia CML, Agasthian T, Lee P. Sublobar resection versus lobectomy for stage IA non-small-cell lung cancer ≤ 2 cm: a systematic review and patient-level meta-analysis. Updates Surg. 2023 Dec;75(8):2343-2354. doi: 10.1007/s13304-023-01627-z. Epub 2023 Aug 10. PMID: 37563486.
Shi Y, Wu S, Ma S, Lyu Y, Xu H, Deng L, Chen X. Comparison Between Wedge Resection and Lobectomy/Segmentectomy for Early-Stage Non-small Cell Lung Cancer: A Bayesian Meta-analysis and Systematic Review. Ann Surg Oncol. 2022 Mar;29(3):1868-1879. doi: 10.1245/s10434-021-10857-7. Epub 2021 Oct 6. PMID: 34613537; PMCID: PMC8493945.
- lobectomy had the lowest hazard ratio of OS than patients received wedge resection, indicating that the overall survival of patients received lobectomy was higher than patients received wedge resection
Li J, Wang Y, Li J, Cao S, Che G. Meta-analysis of Lobectomy and Sublobar Resection for Stage I Non-small Cell Lung Cancer With Spread Through Air Spaces. Clin Lung Cancer. 2022 May;23(3):208-213. doi: 10.1016/j.cllc.2021.10.004. Epub 2021 Oct 23. PMID: 34799251.
肺叶vs亚肺叶切除术研究：JCOG 0802 VS CALGB 140503 VS LCSG
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