Differential efficacy of segmentectomy and wedge resection in sublobar resection compared to lobectomy for solid-dominant stage IA lung cancer: a systematic review and meta-analysis

Q: How does sublobar resection compare with lobectomy for overall survival in solid-dominant stage IA lung cancer?

The pooled analysis found no statistically significant difference in overall survival between sublobar resection and lobectomy (HR = 1.28, 95% CI: 0.98–1.69).

Q: Which sublobar technique showed better recurrence-free survival compared with lobectomy?

Lobectomy was associated with better recurrence-free survival overall (HR = 1.39, 95% CI: 1.10–1.75). The analysis indicates segmentectomy had similar outcomes to lobectomy, while wedge resection was detrimental.

Q: What role do tumor size and consolidation-to-tumor ratio (CTR) play in the study’s findings?

For tumors ≤2 cm, there was no OS difference but recurrence-free survival favored lobectomy, and effects were worse in the 2–3 cm group. When CTR was 0.5 to <1, OS did not differ significantly, but RFS was lower with sublobar resection; CTR = 1 showed significantly lower OS and RFS with sublobar resection.

Sep 21, 2026

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Systematic review and meta-analysis evaluates whether sublobar resection techniques change outcomes compared with lobectomy for solid-dominant stage IA lung cancer. Twenty-six studies, including one randomized trial and retrospective cohorts, were pooled using fixed- or random-effects models. Across 12,667 patients, overall survival was similar, while recurrence-free survival favored lobectomy. Subgroup analyses by tumor size and consolidation-to-tumor ratio (CTR) show variable effects, with wedge resection generally worse, while segmentectomy aligns with lobectomy and wedge may be reasonable for patients aged 75+.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Background

Methods

Results

Overall survival (OS)

Recurrence-free survival (RFS)

Subgroup analyses

Conclusion

Keywords

Systematic review and/or Meta-analysis ’ Differential efﬁcacy of segmentectomy and wedge resection in sublobar resection compared to lobectomy for solid-dominant stage IA lung cancer: a systematic review and meta-analysis Huahang Lin, MDa,b , Zhiyu Peng, MDa,b , Ke Zhou, MSa,b , Linchuan Liang, MSa,b , Jie Cao, MSa,b , Zhaokang Huang, MSa,b , Lonqi Chen, MDa , Jiandong Mei, MDa,b,* Background: Currently, the impact of sublobar resection versus lobectomy on the prognosis of solid-dominant stage IA lung cancer is contradictory in different studies, which requires further exploration. Methods: The authors analyzed 26 studies, including one randomized controlled trial and retrospective cohort studies. Pooled hazard ratios (HRs) and 95% conﬁdence intervals (CIs) were calculated using ﬁxed-effects or random-effects models based on heterogeneity levels. Results: The analysis included 12 667 patients, with 3488 undergoing sublobar resections and 9179 receiving lobectomies. The overall analysis revealed no statistically signiﬁcant difference in overall survival (OS) (HR = 1.28, 95% CI: 0 .98–1.69) between sublobarresection and lobectomy, but lobectomy was associated with better recurrence-free survival (RFS) (HR = 1.39, 95% CI: 1 .10–1.75) . Subgroup analyses revealed that, for tumors with a diameter ≤ 2 cm, sublobar resection versus lobectomy showed no signiﬁcant difference in OS but sublobar resection had lower RFS. For 2–3 cm tumors, both OS and RFS were signiﬁcantly lower in the sublobarresection group. When consolidation-to-tumor ratio (CTR) ranged from 0 .5 to < 1, OS did not differ signiﬁcantly, but RFS was signiﬁcantly lower in sublobar resection. Lung cancers with CTR = 1 showed signiﬁcantly lower OS and RFS in the sublobar resection group. Segmentectomy provided similar OS and RFS compared to lobectomy, while wedge resection had a detrimental effect on patient prognosis. However, wedge resection may have provided comparable outcomes for patients aged 75 years or older. Conclusion: Our ﬁndings suggest that segmentectomy and lobectomy yield similar oncological outcomes. However, compared to lobectomy, wedge resection is associated with a poorer prognosis. Nevertheless, for elderly patients, wedge resection is also a reasonable surgical option. Keywords: lobectomy, lung cancer, solid-dominant, stage IA, sublobar resection aDepartment of Thoracic Surgery, West China Hospital and bWestern China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China Huahang Lin and Zhiyu Peng are co-ﬁrst authors who contributed equally to this work. Lonqi Chen and Jiandong Mei are co-senior authors. Sponsorships or competing interests that maybe relevant to content are disclosed atthe end of this article. *Corresponding author. Address: Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu 610041, People’s Republic of China. Tel./fax: + [86 28 85422494. E-mail: jiandongmei@aliyun.com](86 28 85422494. E-mail: jiandongmei@aliyun.com) (J. Mei). Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution-ShareAlike License 4.0, which allows others to remix, tweak, and build upon the work, even for commercial purposes, as long as the author is credited and the new creations are licensed under the identical terms. International Journal of Surgery (2024) 110:1159–1171 Received 22 August 2023; Accepted 25 October 2023 Supplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal’s website, [www.lww.com/international-journal-of-surgery](www.lww.com/international-journal-of-surgery). Published online 16 November 2023 [http://dx.doi.org/10.1097/JS9.0000000000000896](http://

FAQs

How does sublobar resection compare with lobectomy for overall survival in solid-dominant stage IA lung cancer?

The pooled analysis found no statistically significant difference in overall survival between sublobar resection and lobectomy (HR = 1.28, 95% CI: 0.98–1.69).

Which sublobar technique showed better recurrence-free survival compared with lobectomy?

Lobectomy was associated with better recurrence-free survival overall (HR = 1.39, 95% CI: 1.10–1.75). The analysis indicates segmentectomy had similar outcomes to lobectomy, while wedge resection was detrimental.

What role do tumor size and consolidation-to-tumor ratio (CTR) play in the study’s findings?

For tumors ≤2 cm, there was no OS difference but recurrence-free survival favored lobectomy, and effects were worse in the 2–3 cm group. When CTR was 0.5 to <1, OS did not differ significantly, but RFS was lower with sublobar resection; CTR = 1 showed significantly lower OS and RFS with sublobar resection.

Sep 21, 2026

Uploaded by Patrick