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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Wednesday, January 29, 2025
New research presented at the 2025 Society of Thoracic Surgeons (STS) Annual Meeting indicated that anatomic lung resections, such as lobectomy and segmentectomy, were associated with improved long-term survival compared with wedge resection for patients with early-stage non–small cell lung cancer (NSCLC). The study analyzed outcomes for more than 32,000 patients with stage 1A NSCLC using data from the STS General Thoracic Surgery Database, with long-term follow-up linked to the National Death Index and Centers for Medicare and Medicaid Services database, which provides up to 10 years of survival data.
Lobectomy for stage 1A NSCLC yielded the highest survival rates, with a 5-year overall survival rate of 71.9% and a 10-year overall survival rate of 44.8%. Segmentectomy, which resulted in a 5-year overall survival rate of 69.6% and a 10-year overall survival rate of 44.2%, proved to be a viable alternative. Both lobectomy and segmentectomy demonstrated better outcomes than wedge resection, which had a 5-year overall survival rate of 66.3% and a 10-year overall survival rate of 41.4%.
This research highlights the importance of using real-world data to provide critical insights that complement findings from randomized controlled trials. Although the findings of randomized controlled trials suggest an equivalence between lobectomy and sublobar resections, this real-world study gives clinicians additional insight. It provides a broader perspective applicable to diverse patient populations and health-care settings.
“This study reinforces the need for nuanced decision-making, integrating both randomized controlled trials and real-world data to deliver the highest quality of care,” said Christopher Seder, MD, a thoracic surgeon at Rush University Medical Center, Chicago. “By analyzing outcomes in a variety of health-care settings, we can offer informed recommendations, ultimately improving patient outcomes across the board. This research is a significant step forward in understanding the long-term implications of surgical choices for lung cancer patients. Using real-world data to complement randomized controlled trial findings offers surgeons additional context for tailoring treatment strategies.”
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