Lobar versus Sub-lobar Lung Resection for Early-Stage Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer.
[BACKGROUND] Randomized controlled trials have shown that sub-lobar resections for small peripheral non-small cell lung cancer (NSCLC) are oncologically non-inferior to lobar resections.
- p-value p<0.001
APA
Pohlman A, Odeh B, et al. (2026). Lobar versus Sub-lobar Lung Resection for Early-Stage Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer.. The Annals of thoracic surgery. https://doi.org/10.1016/j.athoracsur.2026.03.045
MLA
Pohlman A, et al.. "Lobar versus Sub-lobar Lung Resection for Early-Stage Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer.." The Annals of thoracic surgery, 2026.
PMID
41933780
Abstract
[BACKGROUND] Randomized controlled trials have shown that sub-lobar resections for small peripheral non-small cell lung cancer (NSCLC) are oncologically non-inferior to lobar resections. However, these studies did not factor in EGFR mutations. In this context, we sought to determine survival differences between sub-lobar and lobar resection for EGFR-mutant vs wild-type NSCLC.
[METHODS] We identified adult patients with ≤2cm NSCLC tested for EGFR mutations between 2021-2022 from a national hospital-based dataset. Patients were split into sub-lobar and lobar resection groups. The main outcome was 3-year overall survival. We used propensity score matching to account for patient demographic and tumor characteristics. Kaplan-Meier survival analyses were used to estimate overall survival.
[RESULTS] There were 6,918 patients with 2,673(38.6%) undergoing sub-lobar and 4,245(61.4%) undergoing lobar resections. EGFR mutations were present in 380(14.2%) sub-lobar resections and 715(16.8%) lobar resections. Patients with EGFR-mutant NSCLC were more likely to be female (74.3% vs 62.0% p<0.001) and Asian (13.9% vs 3.2%, p<0.001). Regardless of resection extent, patients with EGFR-mutant lung cancer had better overall survival compared to EGFR wild-type tumors (94.3% vs 86.8%, p<0.001). Sub-lobar and lobar resections for EGFR-mutant tumors had similar survival (95.3% vs 93.7%, p=0.34), whereas sub-lobar resections for EGFR wild-type tumors had worse survival than lobar resections (84.5% vs 88.3%, p=0.002).
[CONCLUSIONS] EGFR testing prior to surgery may help guide surgical decision-making when it comes to selecting lobar versus sub-lobar resections.
[METHODS] We identified adult patients with ≤2cm NSCLC tested for EGFR mutations between 2021-2022 from a national hospital-based dataset. Patients were split into sub-lobar and lobar resection groups. The main outcome was 3-year overall survival. We used propensity score matching to account for patient demographic and tumor characteristics. Kaplan-Meier survival analyses were used to estimate overall survival.
[RESULTS] There were 6,918 patients with 2,673(38.6%) undergoing sub-lobar and 4,245(61.4%) undergoing lobar resections. EGFR mutations were present in 380(14.2%) sub-lobar resections and 715(16.8%) lobar resections. Patients with EGFR-mutant NSCLC were more likely to be female (74.3% vs 62.0% p<0.001) and Asian (13.9% vs 3.2%, p<0.001). Regardless of resection extent, patients with EGFR-mutant lung cancer had better overall survival compared to EGFR wild-type tumors (94.3% vs 86.8%, p<0.001). Sub-lobar and lobar resections for EGFR-mutant tumors had similar survival (95.3% vs 93.7%, p=0.34), whereas sub-lobar resections for EGFR wild-type tumors had worse survival than lobar resections (84.5% vs 88.3%, p=0.002).
[CONCLUSIONS] EGFR testing prior to surgery may help guide surgical decision-making when it comes to selecting lobar versus sub-lobar resections.