Sublobar resection for non-small cell lung cancer: a narrative review of recent new investigations

Background and Objective: New research supporting sublobar resection for non-small cell lung cancer (NSCLC) has become more prevalent over the past few years. This challenges the previous paradigm of lobectomy as the standard of care for oncologic resection and offers a less aggressive surgical treatment while preserving lung parenchyma and achieving favorable oncologic outcomes. The purpose of this review is to provide the reader with the most up-to-date evidence and clinical applications for sublobar resection in patients with early-stage NSCLC. Methods: We performed a focused literature review using PubMed of studies describing sublobar pulmonary resection in early lung cancer. The review was limited to studies written in English and published after 1950. Studies were included for evaluation based on the title and abstract, and subsequently reviewed in detail by the authors. Key Content and Findings: Sublobar resection compared to lobectomy was associated with similar rates of disease-free survival, however, with significantly less decrease in overall lung function following resection. Conclusions: In appropriately selected patients with early NSCLC, available data now suggest that sublobar resection offers equivalent oncologic outcomes with greater volume of remaining lung parenchyma, which may lead to better long-term pulmonary function. Further investigation regarding sublobar resection is warranted to encompass the broader patient population, as well as incorporate postoperative quality of life metrics.