Real-World Study: Lobectomy Linked With Higher OS Rates Than Wedge Resection in Early-Stage NSCLC

Lobectomy is associated with improved long-term survival compared with wedge resection for patients with early-stage non-small cell lung cancer (NSCLC), according to research presented at the 2025 Society of Thoracic Surgeons (STS) Annual Meeting.

These findings mark “a significant step forward in understanding the long-term implications of surgical choices” for patients with lung cancer, according to a statement from study author and thoracic surgeon Christopher Seder, MD, of Rush University Medical Center in Chicago, who noted that using the real-world data to complement findings from randomized controlled trials “offers surgeons additional context for tailoring treatment strategies.”

Dr. Seder and colleagues analyzed outcomes of more than 32,000 patients with stage 1A NSCLC by using data from the STS General Thoracic Surgery database, as well as long-term follow-up linked to the National Death Index and Centers for Medicare and Medicaid Services database. The STS General Thoracic Surgery Database includes “a majority of lung cancer and esophageal cancer surgeries performed in the US” and serves as a “true national benchmark, capturing detailed information on patient characteristics, surgical procedures, and outcomes,” STS officials said.

The study showed that lobectomy for stage 1A NSCLC was associated with the highest survival rates, showing a five-year overall survival (OS) rate of 71.9% and a 10-year OS rate of 44.8%. Segmentectomy had a five-year OS rate of 69.6% and a 10-year OS rate of 44.2%, proving to be a “viable alternative” to lobectomy. Wedge resection showed the lowest OS rates among the procedures, demonstrating a five-year OS rate of 66.3% and a 10-year OS rate of 41.4%.

“This research highlights the profound effect of using real-world data to provide critical insights that complement findings from randomized controlled trials (RCTs),” STS officials said in a news release.
“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.”

Dr. Seder explained the implications of the findings and why it was important to evaluate real-world outcomes with different surgical approaches.

“This study reinforces the need for nuanced decision-making, integrating both RCTs and real-world data to deliver the highest quality of care,” Dr. Seder said in a statement. “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,” STS officials said in the release.

At top, Christopher Seder, MD, of Rush University Medical Center in Chicago, presents the study at the 2025 Society of Thoracic Surgeons Annual Meeting. (Photo courtesy of the Society of Thoracic Surgeons)

Source: STS