Sublobar resection versus lobectomy in the treatment of synchronous multiple primary lung cancer

Sep 24, 2026

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Objective: Synchronous multiple primary lung cancers (sMPLCs) are common in clinical practice, but the optimal surgical approach for the main lesion remains under exploration. This study analyzes the prognosis of sMPLCs and single primary lung cancers with similar tumor stages and evaluates whether sublobar resection yields a prognosis comparable to lobectomy. Methods: One-hundred forty-one sMPLC cases were compared between lobectomy (n=65) and sublobar resection (n=76) groups, with single primary lung cancer cases matched at 1:1 using propensity score matching; short-term perioperative outcomes, 5-year disease-free survival, and 5-year overall survival were assessed. Results: Overall survival and disease-free survival showed no significant differences between groups within sMPLC cohorts, while sublobar resection reduced postoperative complications and shortened postoperative hospital stay. Conclusion: Prognosis generally depends on main tumor state without statistical differences between surgical procedures, and sublobar resection is safer in the perioperative period.

LanguageEnglish

CategoryHealthcare

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Pages11

Reading Time28 min

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Niu etal. World Journal of Surgical Oncology (2023) 21:135 [https://doi.org/10.1186/s12957-023-02996-w](https://doi.org/10.1186/s12957-023-02996-w) World Journal of Surgical Oncology RESEARCH Open Access Sublobar resection versus lobectomyin the treatment of synchronous multiple primary lung cancer Niu Niu1, Liang Zhou2, Junjie Zhao1, Xingjie Ma1, Fan Yang1 and Weibo Qi1* Abstract Objective Although synchronous multiple primary lung cancers (sMPLCs) are common in clinical practice, the choice of surgical modalities for the main lesion is still at the stage of exploration. This study is designed to analyze the prognosis of sMPLCs and single primary lung cancers with similar tumor stages and to explore whether sublobarresection has a similar prognosis as lobectomy for sMPLCs. Methods One-hundred forty-one cases of sMPLCs were selected, including the following: 65 cases underwent lobectomy for main lesions, and 76 cases underwent sublobar resection for main lesions. One thousand one hundred forty-four cases of single primary lung cancer were matched at 1:1 by propensity score matching. Then, the patients with sMPLCs were divided into a lobectomy group and a sublobar group according to the first tumor stage. Ninetyeight cases of patients with sMPLCs were matched. The short-term perioperative effect, 5-year disease-free survival (DFS) rate, and 5-year overall survival (OS) rate between the two groups were compared. Results There was no significant difference in OS between sMPLCs and single primary lung cancer after lobectomy (77 . 1% vs. 77. 2%, P= 0 . 157) and sublobar resection (98 . 7% vs. 90. 7%, P= 0 . 309) . There was no significant difference in OS (86 . 7% vs. 83. 9%, P= 0 .482) or DFS (67 . 6 vs. 87. 7%, P= 0 . 324) between the lobectomy group and sublobar group with sMPLCs. The sublobar resection group obtained a lower incidence of postoperative complications (40 . 8% vs. 16. 3%, P= 0 . 007) and shorter postoperative hospital stay (11 . 22 vs. 9. 27, P= 0 . 049) . Conclusion The prognosis of patients with sMPLCs generally depends on the main tumor state, which has no statistical difference regardless of sublobar resection or lobectomy, and the perioperative period of sublobar resection is safer than that of lobectomy. Keywords Lobectomy, Sublobar resection, Synchronous multiple primary lung cancer Key question Is there a difference in the survival of sMPLCs and single primary lung cancers with similar tumor stages? Does sublobar resection have the similar prognosis as lobectomy for sMPLCs? *Correspondence: Weibo Qi qiweibo1 [121@163.com](121@163.com) 1 Department of Cardiothoracic Surgery, First Hospital of Jiaxing (Affiliated Hospital of Jiaxing University), Jiaxing 314000, China 2 Graduate School of Bengbu Medical College, Bengbu 233000, China Key findings There was no difference in survival between sMPLCs and single primary lung cancer after lobectomy and sublobarresection. There was no significant difference in survival between the lobectomy group and sublobar group with sMPLCs. © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0

FAQs

What is the main research objective of this study?

To compare prognosis between sublobar resection and lobectomy for synchronous multiple primary lung cancer (sMPLC) patients, and to evaluate whether outcomes match for tumors with similar stages.

How were patients assigned to surgical groups?

A total of 141 sMPLC cases were selected, with 65 undergoing lobectomy and 76 undergoing sublobar resection; additional matching with single primary lung cancer used 1:1 propensity score matching.

Did lobectomy and sublobar resection differ in survival outcomes?

No significant differences were found in overall survival (OS) or disease-free survival (DFS) between the lobectomy and sublobar resection groups among sMPLC patients.

What perioperative advantages were observed with sublobar resection?

Sublobar resection showed a lower incidence of postoperative complications and a shorter postoperative hospital stay compared with lobectomy.

Sep 24, 2026

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