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

The Society of Thoracic Surgeons (STS) Expert Consensus Document (2026) on Addressing Definition and Practices of Sublobar Resection in Non-Small Cell Lung Cancer (NSCLC) provides evidence-based recommendations to guide the rapidly increasing use of sublobar resection following the landmark CALGB 140503 and JCOG0802 trials. Using a structured Delphi consensus process, an expert panel from the STS developed 21 recommendations addressing key controversies in the management of early-stage NSCLC. The panel concluded that, for carefully selected patients with peripheral, node-negative NSCLC ≤2 cm, sublobar resection—including both segmentectomy and wedge resection—offers oncologic outcomes comparable to lobectomy when adequate margins and lymph node assessment are achieved. The document emphasizes the importance of meticulous nodal staging, appropriate margin selection, surgeon experience in complex segmentectomy, and individualized decision-making when occult nodal disease or spread through air spaces (STAS) is present. Importantly, lobectomy remains the standard of care for tumors measuring 2–3 cm.