Segmentectomy vs Lobectomy in Early Lung Cancer: Re-evaluating Surgical Strategies After Randomized Trials

Recent randomized trials have profoundly reshaped the surgical management of early-stage non-small cell lung cancer. The results of the JCOG0802/WJOG4607L and CALGB 140503 trials have challenged the long-standing paradigm that lobectomy should remain the universal standard for small peripheral tumors.

Initial analyses suggested that anatomical segmentectomy may achieve comparable oncologic outcomes while preserving lung function. However, the recently reported long-term results, including 10-year follow-up data, have renewed the discussion regarding the true role of segmentectomy in contemporary thoracic oncology.

Important questions remain open, including optimal patient selection, margin requirements, lymph node management, the impact of tumor biology, and the role of minimally invasive and robotic approaches.

This Research Topic aims to critically re-evaluate the role of sublobar resections in the treatment of early-stage lung cancer in light of emerging long-term evidence, fostering a multidisciplinary discussion among thoracic surgeons, oncologists, and imaging specialists.

The scope of this Research Topic focuses on patients with early-stage lung cancer undergoing curative-intent surgical resection, with particular emphasis on the evolving role of sublobar resections in the context of recent randomized evidence.

We aim to explore how findings from pivotal trials comparing segmentectomy and lobectomy are reshaping surgical decision-making in clinical practice, including their implications for patient selection, operative strategies, and long-term oncologic and functional outcomes.

We invite only Original Research, Review, Mini Review, and Perspective articles addressing, but not limited to, the following topics:

• Interpretation and clinical implications of randomized trials in lung cancer surgery

• Segmentectomy versus lobectomy: oncologic and long-term outcomes

• Patient selection criteria and risk stratification for sublobar resections

• Margin adequacy and spread through air spaces (STAS)

• Lymph node assessment and management in segmentectomy

• Technical aspects and outcomes of VATS and robotic segmentectomy

• Functional outcomes and lung preservation strategies

• Segmentectomy in screen-detected lung cancer

• Management of multiple primary lung cancers

• Imaging, radiomics, and surgical planning

• Future directions in lung-sparing surgery

Please note: manuscripts consisting solely of bioinformatics or computational analysis of public databases, not supported by validation in independent cohorts or biological/clinical studies, are out of scope and will not be considered for this collection.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: lung cancer, randomized trials, long-term outcomes, sublobar resection, segmentectomy, VATS, robotic surgery

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.