Journal Review in Thoracic Surgery: Lobar vs Sublobar Resection for Stage 1A NSCLC – CALGB & JCOG

In this episode our team reviews the two groundbreaking RCTs which challenged the long-held dogma that a lobectomy is the only acceptable oncologic procedure for NSCLC. Listen as we compare and contrast the North American CALGB trial and Japanese JCOG trial which were both designed to investigate survival and recurrence outcomes by randomizing stage 1A patients to lobectomy versus a sublobar resection.



Learning Objectives:

-Compare and contrast the patient characteristics of the CALGB and JCOG trials

-Understand the methodology each trial and be able to explain their nuanced differences

-Analyze the results of the CALGB and JCOG trials and how they apply to patients today



Hosts:

Kelly Daus MD, Peter White MD, Eric Vallieres, MD and Brian Louie MD



Referenced Material

https://pubmed.ncbi.nlm.nih.gov/36780674/

Altorki N, et al. Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer. N Engl J Med. 2023 Feb 9;388(6):489-498. doi: 10.1056/NEJMoa2212083. PMID: 36780674; PMCID: PMC10036605.



https://pubmed.ncbi.nlm.nih.gov/35461558/’

Saji H, et al. West Japan Oncology Group and Japan Clinical Oncology Group. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022 Apr 23;399(10335):1607-1617. doi: 10.1016/S0140-6736(21)02333-3. PMID: 35461558.



https://pubmed.ncbi.nlm.nih.gov/37473998/

Altorki N, et al. Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: A post hoc analysis of CALGB 140503 (Alliance). J Thorac Cardiovasc Surg. 2023 Jul 18:S0022-5223(23)00612-8. doi: 10.1016/j.jtcvs.2023.07.008. Epub ahead of print. PMID: 37473998.



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