Anatomic lung resection, such as lobectomy and segmentectomy, offered better long-term survival than wedge resection for patients with early-stage non-small cell lung cancer.


RT’s Three Key Takeaways:

  1. Lobectomy Provides Best Survival Rates: Lobectomy, a type of anatomic lung resection, demonstrated the highest five-year and 10-year overall survival rates for stage 1A non-small cell lung cancer, outperforming both segmentectomy and wedge resection.
  2. Segmentectomy Is a Viable Alternative: While slightly less effective than lobectomy, segmentectomy also showed superior long-term survival compared to wedge resection.
  3. Real-World Data Adds Insight: The study highlights the value of large-scale, real-world data in complementing randomized controlled trials, offering clinicians a broader perspective to inform treatment strategies.

Anatomic lung resections, such as lobectomy and segmentectomy, are associated with improved long-term survival compared to wedge resection for patients with early-stage non-small cell lung cancer (NSCLC), according to new research presented at the 2025 Society of Thoracic Surgeons (STS) Annual Meeting.

The study analyzed outcomes for more than 32,000 stage 1A NSCLC patients 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 offered the highest survival rates, with a five-year overall survival (OS) of 71.9% and 10-year OS of 44.8%. Segmentectomy, which resulted in a five-year OS of 69.6% and 10-year OS of 44.2% proved to be a viable alternative. Both lobectomy and segmentectomy demonstrated better outcomes than wedge resection, which had five-year OS of 66.3% and 10-year OS of 41.4%.

Real-World Data for Surgical Decision-Making in Lung Cancer Treatment

This research highlights the profound effect of using real-world data to provide critical insights that complement findings from randomized controlled trials (RCTs). While RCTs suggest an equivalence between lobectomy and sub-lobar resections, this real-world study gives 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,” says Christopher Seder, MD, a thoracic surgeon at Rush University Medical Center, in a release. “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 time when cardiothoracic surgical practices are evolving, integrating innovative tools and approaches that prioritize patient safety and long-term health. Seder adds in a release, “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.”

The STS General Thoracic Surgery Database, part of the STS National Database, includes a majority of lung cancer and esophageal cancer surgeries performed in the US. It is a national benchmark, capturing information on patient characteristics, surgical procedures, and outcomes. Researchers say the study highlights the value of large-scale, real-world data analysis in informing clinical practice and guiding patient care.

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