Oncologic outcomes of sublobar resection in non-small cell lung cancer ≤3 cm with adverse pathologic features.

Authors

Taeyoung Yun, Dongsun Lee, Ji Hyeon Park, Kwon Joong Na, Hyun Joo Lee, In Kyu Park, Chang Hyun Kang, Young Tae Kim, Samina Park

Published in

Interdisciplinary cardiovascular and thoracic surgery. Oct 13, 2026. Epub Oct 13, 2026.

Abstract

This study evaluated the association between resection extent and recurrence-free survival in patients with clinically node-negative NSCLC ≤3 cm with adverse pathologic features including visceral pleural invasion, spread through air spaces (STAS), or high-grade histology.
We retrospectively reviewed patients who underwent curative-intent resection for cN0M0 NSCLC with pathologic tumor size ≤3 cm between 2017 and 2023. Patients were categorized into sublobar resection and lobectomy groups. Cox proportional hazards models were used to identify factors associated with recurrence-free survival. Propensity-score weighting was used to account for measured differences between the surgical groups, followed by weighted survival analyses within prespecified individual and combined adverse-feature subgroups.
Among 1,774 patients, 666 underwent sublobar resection and 1,108 underwent lobectomy. Visceral pleural invasion, STAS, and high-grade histology were independently associated with a higher risk of recurrence. Lobectomy was not independently associated with recurrence-free survival in multivariable analysis (HR, 1.17; 95% CI, 0.69-1.98, p = 0.562). In unadjusted subgroup analyses, recurrence-free survival did not significantly differ by resection extent among patients with visceral pleural invasion, STAS, or high-grade histology with similar findings in combined subgroups (p > 0.05). Weighting reduced the baseline imbalances, while the resulting survival curves remained largely overlapping across the individual adverse-feature subgroups.
Visceral pleural invasion, STAS, and high-grade histology were independently associated with recurrence, whereas resection extent was not. The weighted analysis did not show a clear separation between surgical groups, although the present analysis was not designed to demonstrate comparable efficacy between the two surgical approaches.

PMID:
42867137
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.

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