STS Expert Consensus Document (2026) on Addressing Definition and Practices of Sublobar Resection in Non-small Cell Lung Cancer

Two recent randomized clinical trials have shown sublobar resection to be non-inferior to lobectomy in node negative non-small cell lung cancer (NSCLC) <= 2cm. As a result, the utilization of sublobar resection in early lung cancer patients has significantly increased. Consensus recommendations are needed to guide its appropriate use.

The Society of Thoracic Surgeons Workforce on Evidence-Based Surgery assembled a panel of thoracic surgeons with clinical and methodological expertise to review the existing literature on this topic. A modified Delphi method, with parameters and thresholds determined a priori, was utilized until 75% agreement on the statements was reached.

The panel identified 7 key areas of controversy. Three rounds of voting were required to reach >75% agreement on 21 statements to help guide appropriate utilization of sublobar resection in early-stage lung cancer.

Despite results of recent randomized clinical trials, several key questions remain regarding sublobar resection for early-stage NSCLC. These statements will provide further guidance for clinicians considering the different surgical options.

Published by The Annals of thoracic surgery, 2026. The guideline itself is at the source linked here.

doi.org/10.1016/j.athoracsur.2026.06.015