JTHO August 2025

Seder et al conducted a comparative effectiveness analysis evaluating the long-term survival of “real world” patients and found anatomic resection (lobectomy, segmentectomy) is associated with improved OS and LCSS compared with wedge resection in patients with stage IA NSCLC ( 2 cm). What are potential explanations for this finding?

Sublobar resections were used as “compromise” operations in certain patients who were deemed unfit for lobectomy.
The wedge resection cohort had inferior rates of lymph node sampling
The reduced rate of nodal upstaging with wedge resections may have resulted in some patients being denied potentially beneficial systemic adjuvant therapy
All of the above