Illinois [US], January 27 : New research presented at the 2025 Society of Thoracic Surgeons (STS) Annual Meeting reveals that anatomic lung resections, such as lobectomy and segmentectomy, are associated with better long-term survival than wedge resection for patients with early-stage non-small cell lung cancer (NSCLC).
The study analysed outcomes for more than 32,000 stage 1A NSCLC patients using data from the STS General Thoracic Surgery Database (STS GTSD), 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 offered the highest survival rates, with a 5-year overall survival (OS) of 71.9 per cent and 10-year OS of 44.8 per cent. Segmentectomy, which resulted in a 5-year OS of 69.6 per cent and a 10-year OS of 44.2 per cent, proved to be a viable alternative. Both lobectomy and segmentectomy demonstrated better outcomes than wedge resection, which had a 5-year OS of 66.3 per cent and a 10-year OS of 41.4 per cent.
This research highlights the profound effect of using real-world data to provide critical insights that complement findings from randomised controlled trials (RCTs). While RCTs suggest an equivalence between lobectomy and sub-lobar resections, this real-world study offers clinicians additional insight. It provides a broader perspective applicable to diverse patient populations and healthcare settings.
"This study reinforces the need for nuanced decision-making, integrating both RCTs 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 healthcare settings, we can offer informed recommendations, ultimately improving patient outcomes across the board."
The findings come at a pivotal time when cardiothoracic surgical practices are evolving rapidly, integrating innovative tools and approaches that prioritize patient safety and long-term health. Dr Seder added, "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 RCT findings offers surgeons additional context for tailoring treatment strategies."
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