The Society of Thoracic Surgeons Expert Consensus Document (2026) on Addressing Definition and Practices of Sublobar Resection in Non-Small Cell Lung Cancer.

Abstract

Two recent randomized clinical trials have shown sublobar resection to be noninferior to lobectomy in node-negative non-small cell lung cancer ≤2 cm. As a result, the use 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 boundaries and thresholds determined a priori, was used 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 use 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 non-small cell lung cancer. These statements will provide further guidance for clinicians considering the different surgical options.