When wedge resection is good enough: Survival outcomes and nodal involvement of ground-glass-dominant stage IA non-small cell lung cancer.
[OBJECTIVE] Whether the indications for wedge resection can be extended to early-stage non-small cell lung cancer (NSCLC) remains unclear.
APA
Oka N, Yotsukura M, et al. (2026). When wedge resection is good enough: Survival outcomes and nodal involvement of ground-glass-dominant stage IA non-small cell lung cancer.. JTCVS open, 29, 101549. https://doi.org/10.1016/j.xjon.2025.101549
MLA
Oka N, et al.. "When wedge resection is good enough: Survival outcomes and nodal involvement of ground-glass-dominant stage IA non-small cell lung cancer.." JTCVS open, vol. 29, 2026, pp. 101549.
PMID
41960127
Abstract
[OBJECTIVE] Whether the indications for wedge resection can be extended to early-stage non-small cell lung cancer (NSCLC) remains unclear. We investigated the survival outcomes and nodal involvement of ground-glass-opacity-dominant stage IA NSCLC undergoing wedge resection, segmentectomy, or lobectomy.
[METHODS] We retrospectively investigated the prognostic and clinicopathological outcomes of patients who underwent lung resection for ground-glass-opacity-dominant clinical stage IA (diameter ≤3 cm; consolidation-to-tumor ratio ≤0.5) NSCLC between 2017 and 2022. Patients with tumors ≤2 cm and consolidation-to-tumor ratio ≤0.25 were excluded. Propensity score matching was performed to equalize the preoperative characteristics of patients undergoing wedge resection and segmentectomy. Overall and relapse-free survival rates were estimated, and differences were compared.
[RESULTS] Of the 398 patients who met the inclusion criteria, 77, 258, and 63 underwent lobectomy, segmentectomy, and wedge resection, respectively. Two (0.5%) patients experienced disease recurrence, and 6 (1.5%) patients died; however, no lung cancer-related deaths were observed. Two patients developed locoregional recurrence, all of which were nodal. No patients had pN1/2 disease. The 5-year overall and relapse-free survival rates were 97.6% and 96.4%, respectively. Relapse-free survival did not differ significantly according to the extent of lung resection (91.7%, 97.7%, and 100%; = .146). Even after propensity score matching, overall and relapse-free survival did not differ significantly between wedge resection and segmentectomy.
[CONCLUSIONS] Patients with ground-glass-opacity-dominant clinical stage IA NSCLC showed an excellent prognosis, with no survival differences between procedures. In those patients, wedge resection without nodal dissection may be oncologically equivalent to anatomic resection.
[METHODS] We retrospectively investigated the prognostic and clinicopathological outcomes of patients who underwent lung resection for ground-glass-opacity-dominant clinical stage IA (diameter ≤3 cm; consolidation-to-tumor ratio ≤0.5) NSCLC between 2017 and 2022. Patients with tumors ≤2 cm and consolidation-to-tumor ratio ≤0.25 were excluded. Propensity score matching was performed to equalize the preoperative characteristics of patients undergoing wedge resection and segmentectomy. Overall and relapse-free survival rates were estimated, and differences were compared.
[RESULTS] Of the 398 patients who met the inclusion criteria, 77, 258, and 63 underwent lobectomy, segmentectomy, and wedge resection, respectively. Two (0.5%) patients experienced disease recurrence, and 6 (1.5%) patients died; however, no lung cancer-related deaths were observed. Two patients developed locoregional recurrence, all of which were nodal. No patients had pN1/2 disease. The 5-year overall and relapse-free survival rates were 97.6% and 96.4%, respectively. Relapse-free survival did not differ significantly according to the extent of lung resection (91.7%, 97.7%, and 100%; = .146). Even after propensity score matching, overall and relapse-free survival did not differ significantly between wedge resection and segmentectomy.
[CONCLUSIONS] Patients with ground-glass-opacity-dominant clinical stage IA NSCLC showed an excellent prognosis, with no survival differences between procedures. In those patients, wedge resection without nodal dissection may be oncologically equivalent to anatomic resection.