Differences in patterns of relapse and survival after relapse between lobectomy and sublobar resection for stage IA non-small cell lung cancer.
- 1Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.
- 2Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Abstract
Objective
In the Japan Clinical Oncology Group 0802 trial, lung cancer-specific mortality was comparable between lobectomy and segmentectomy despite a higher rate of locoregional relapse after segmentectomy. We evaluated relapse patterns and postrelapse survival following lobectomy or sublobar resection.Methods
This single-institution retrospective study included patients who underwent surgery for primary non-small cell lung cancer (NSCLC) between 2003 and 2022 and subsequently developed relapse. Overall survival was defined as the period from surgery (OS1) or from the date of relapse diagnosis (OS2) to death from any cause.Results
Among 362 patients with clinical stage IA NSCLC who developed relapse, isolated locoregional relapse accounted for 110 of 297 relapsed patients (37.0%) after lobectomy and 36 of 65 relapsed patients (55.4%) after sublobar resection. Among 59 patients treated with local consolidative therapy for isolated locoregional relapse, the 4-year OS2 rate was 76.4% (95% CI, 64.9%-89.8%). After inverse probability of treatment weighting, the 7-year OS1 rates were 49.3% (95% CI, 42.2%-57.6%) after lobectomy and 64.9% (95% CI, 52.4%-80.3%) after sublobar resection, and the 4-year OS2 rates were 49.6% (95% CI, 42.4%-57.9%) and 62.7% (95% CI, 49.5%-79.3%), respectively.Conclusions
In this exploratory cohort of patients who developed postoperative relapse, relapse patterns differed between surgical groups, with isolated locoregional relapse representing a larger proportion of relapse in the sublobar resection group. Long-term survival was observed in selected patients treated with modern postrelapse therapies, including local consolidative therapy. These findings should be interpreted cautiously as hypothesis-generating.
Related
- Clinicopathological Significance of Extra‐Alveolar Invasion in Lung Adenocarcinomas Treated With Sublobar Resection
- Outcomes Based on Age in CALGB 140503 (Alliance): Lobar vs. Sublobar Resection for Peripheral Stage IA Non–Small Cell Lung Cancer
- Carinal Resection and Extended Sleeve Lobectomy After Right Upper Sleeve Lobectomy: 1 Step Beyond
- Nodule Dye-Localization Using Interventional Fluoroscopy for Image-Guided Sublobar Lung Resection.
- Comparison of oncological outcomes between adenocarcinoma and squamous cell carcinoma after sublobar resection for T1a/bN0M0 non-small cell lung cancer: a propensity score-matched SEER study.
BibTeX
@article{adachi2026differences,
title = {{Differences in patterns of relapse and survival after relapse between lobectomy and sublobar resection for stage IA non-small cell lung cancer.}},
author = {Masahiro Adachi and Yukihiro Yoshida and Chihiro Takemura and Masaya Yotsukura and Tomohiro Haruki and Hidehito Horinouchi and Yasushi Goto and Shun-Ichi Watanabe},
journal = {JTCVS open},
year = {2026},
month = jul,
doi = {10.1016/j.xjon.2026.101952},
url = {https://europepmc.org/article/MED/42948192},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Differences in patterns of relapse and survival after relapse between lobectomy and sublobar resection for stage IA non-small cell lung cancer.
AU - Masahiro Adachi
AU - Yukihiro Yoshida
AU - Chihiro Takemura
AU - Masaya Yotsukura
AU - Tomohiro Haruki
AU - Hidehito Horinouchi
AU - Yasushi Goto
AU - Shun-Ichi Watanabe
PY - 2026
DA - 2026/07/04
JO - JTCVS open
DO - 10.1016/j.xjon.2026.101952
UR - https://europepmc.org/article/MED/42948192
AB - Objective In the Japan Clinical Oncology Group 0802 trial, lung cancer-specific mortality was comparable between lobectomy and segmentectomy despite a higher rate of locoregional relapse after segmentectomy. We evaluated relapse patterns and postrelapse survival following lobectomy or sublobar resection.Methods This single-institution retrospective study included patients who underwent surgery for primary non-small cell lung cancer (NSCLC) between 2003 and 2022 and subsequently developed relapse. Overall survival was defined as the period from surgery (OS1) or from the date of relapse diagnosis (OS2) to death from any cause.Results Among 362 patients with clinical stage IA NSCLC who developed relapse, isolated locoregional relapse accounted for 110 of 297 relapsed patients (37.0%) after lobectomy and 36 of 65 relapsed patients (55.4%) after sublobar resection. Among 59 patients treated with local consolidative therapy for isolated locoregional relapse, the 4-year OS2 rate was 76.4% (95% CI, 64.9%-89.8%). After inverse probability of treatment weighting, the 7-year OS1 rates were 49.3% (95% CI, 42.2%-57.6%) after lobectomy and 64.9% (95% CI, 52.4%-80.3%) after sublobar resection, and the 4-year OS2 rates were 49.6% (95% CI, 42.4%-57.9%) and 62.7% (95% CI, 49.5%-79.3%), respectively.Conclusions In this exploratory cohort of patients who developed postoperative relapse, relapse patterns differed between surgical groups, with isolated locoregional relapse representing a larger proportion of relapse in the sublobar resection group. Long-term survival was observed in selected patients treated with modern postrelapse therapies, including local consolidative therapy. These findings should be interpreted cautiously as hypothesis-generating.
SN - 2666-2736
ER -