Recent research presented at the 2025 Society of Thoracic Surgeons (STS) Annual Meeting has shed light on the survival benefits of anatomic lung resections, specifically lobectomy and segmentectomy, for patients diagnosed with stage 1A non-small cell lung cancer (NSCLC). Utilizing data from the STS General Thoracic Surgery Database, which was linked to long-term survival data from the National Death Index and the Centers for Medicare and Medicaid Services, the study evaluated outcomes for over 32,000 patients. This comprehensive analysis uncovered notable findings that have significant implications for the treatment of early-stage NSCLC.
The study revealed that lobectomy, which involves the removal of an entire lobe of the lung, yielded the highest survival rates. Patients who underwent lobectomy experienced a 5-year overall survival (OS) rate of 71.9% and a 10-year OS rate of 44.8%. These impressive survival statistics underscore the efficacy of lobectomy as a treatment option for stage 1A NSCLC. Segmentectomy, another form of anatomic resection that involves removing a segment of the lung, also demonstrated strong outcomes. With a 5-year OS of 69.6% and a 10-year OS of 44.2%, segmentectomy proved to be a viable alternative to lobectomy.
Comparing Anatomic Resections and Wedge Resections
In stark contrast to the survival rates achieved through lobectomy and segmentectomy, patients who underwent wedge resection had comparatively lower survival outcomes. Wedge resections involve removing a small, wedge-shaped portion of the lung that contains the cancerous tissue, and this procedure resulted in a 5-year OS of 66.3% and a 10-year OS of 41.4%. The significant differences in survival rates among these procedures highlight the clear survival advantages of anatomic resections over wedge resections for patients with early-stage NSCLC.
Dr. Christopher Seder from Rush University Medical Center emphasized the importance of integrating both randomized controlled trials (RCTs) and real-world data to make informed decisions. While RCTs provide controlled environments ideal for comparison, real-world studies offer insights that can encompass a broader range of patient populations and healthcare settings. By combining these two sources of data, clinicians can gain a more nuanced understanding of how different surgical approaches impact long-term survival outcomes, leading to higher-quality patient care.
The Value of Real-World Data
The research underscores the critical role of utilizing real-world data to provide valuable insights that complement findings from RCTs. Real-world data analyses allow for the inclusion of a diverse patient population, capturing a broader spectrum of health circumstances and surgical outcomes. This approach ensures that the findings are more applicable to everyday medical practice and patient care. Large-scale, real-world data analysis is thus essential for informing clinical practice and guiding patient care, especially as cardiothoracic surgical practices evolve with new tools and approaches that prioritize patient safety and long-term health.
The STS General Thoracic Surgery Database (GTSD) plays a pivotal role as a national benchmark, capturing detailed information on patient characteristics, surgical procedures, and outcomes. This data repository enriches the understanding of how various surgical approaches impact patient survival and recovery. It reinforces the value of comprehensive data collection in shaping treatment strategies and improving patient outcomes. By continually gathering and analyzing real-world data, medical professionals can stay current with emerging trends and refine their practices to deliver better care.
Implications for Clinical Decision-Making
Recent research presented at the 2025 Society of Thoracic Surgeons (STS) Annual Meeting has highlighted the survival benefits of anatomic lung resections, specifically lobectomy and segmentectomy, for patients with stage 1A non-small cell lung cancer (NSCLC). This study, using data from the STS General Thoracic Surgery Database linked with long-term survival information from the National Death Index and the Centers for Medicare and Medicaid Services, evaluated outcomes for more than 32,000 patients. The comprehensive analysis produced significant findings that impact early-stage NSCLC treatment.
The research found that lobectomy, which involves removing an entire lung lobe, resulted in the highest survival rates. Patients who had a lobectomy achieved a 5-year overall survival (OS) rate of 71.9% and a 10-year OS rate of 44.8%. These impressive statistics highlight the effectiveness of lobectomy for stage 1A NSCLC. Segmentectomy, an alternative that involves removing a lung segment, also showed strong results, with a 5-year OS of 69.6% and a 10-year OS of 44.2%, making it a viable option as well.
