{"doi":"10.1016/j.jtcvs.2025.12.018","title":"Extent of resection for spread-through air spaces−positive stage IA1-2 non−small cell lung cancer","abstract":null,"journal":"The Journal of Thoracic and Cardiovascular Surgery","year":2026,"id":610941,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":43398,"name":"Mari Mino-Kenudson","orcid":null,"position":1,"is_corresponding":false},{"id":302550,"name":"Michael Lanuti","orcid":"0000-0001-6049-1276","position":2,"is_corresponding":false},{"id":1267702,"name":"Chi-Fu Jeffrey Yang","orcid":"0000-0002-7584-6030","position":3,"is_corresponding":false},{"id":1491310,"name":"Paul W. Furlow","orcid":"0000-0002-0754-4962","position":4,"is_corresponding":false},{"id":492362,"name":"Zhizhou Yang","orcid":"0000-0002-0921-3606","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Extent of resection for spread-through air spaces−positive stage IA1-2 non−small cell lung cancer","abstract":"<h4>Objectives</h4>Sublobar resection has demonstrated noninferiority to lobectomy in unselected stage IA non-small cell lung cancer (NSCLC), but the optimal surgical approach in tumors with spread-through air spaces (STAS) remains unclear. This study examines how extent of resection influences clinical outcomes in patients with STAS-positive stage IA1-2 NSCLC.<h4>Methods</h4>Patients who underwent lung resection for primary pathologic stage IA1-2 NSCLC between February 2018 and January 2022 at a tertiary academic institution were included. In the STAS-positive cohort, multivariable competing risk models were used to assess cumulative incidence of recurrence and lung cancer-related death after lobectomy versus sublobar resection, and propensity score-matched analysis was performed for overall survival and recurrence-free survival. Exploratory analysis was performed to evaluate outcomes after specific resection type (lobectomy, segmentectomy, wedge) in the STAS-positive cohort.<h4>Results</h4>A total of 445 patients met inclusion criteria, of whom 158 (35.5%) were STAS-positive. Within the STAS-positive cohort, recurrence was significantly more frequent after sublobar resection (subdistribution hazard ratio, 7.60; 95% confidence interval, 1.85-31.33, P = .005), and lung cancer-specific mortality was higher (subdistribution hazard ratio, 5.12; 95% confidence interval, 1.03-25.62; P = .047). Propensity-score matching yielded 40 well-balanced pairs. Overall survival was similar between lobectomy and sublobar resection (5-year overall survival: lobectomy 91.5% vs sublobar 80.3%, P = .18). In contrast, recurrence-free survival was significantly worse after sublobar resection (5-year recurrence-free survival: lobectomy 88.8% vs sublobar 66.1%, P = .042). On exploratory analysis, inferior recurrence-free survival was observed for wedge resection (P = .024) but not for segmentectomy (P = .324) when compared with lobectomy.<h4>Conclusions</h4>Sublobar resection, particularly wedge resection, is associated with worse recurrence-free survival for STAS-positive stage IA1-2 NSCLC.","is_dataset_classified":null,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41443465","pmcid":null,"openalex_id":"https://openalex.org/W7116735303","authors":[],"funders":[],"total_grants":0,"fwci":1.5518,"citation_percentile":0.85889519,"influential_citations":0,"citation_trend":[{"year":2026,"count":2}],"oa_status":"closed","license":null,"oa_locations":[{"url":"https://doi.org/10.1016/j.jtcvs.2025.12.018","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/41443465","host_type":"repository"}],"fields_of_study":["Lung Cancer Diagnosis and Treatment","Lung Cancer Research Studies","Lung Cancer Treatments and Mutations"],"mesh_terms":["Aged","Carcinoma, Non-Small-Cell Lung","Female","Humans","Lung Neoplasms","Male","Middle Aged","Neoplasm Recurrence, Local","Neoplasm Staging","Pneumonectomy","Retrospective Studies","Risk Factors"],"keywords":["Stage (stratigraphy)","Lung cancer","Resection","Wedge resection","Cancer","Recurrence","Lobectomy","Segmentectomy","Sublobar Resection","Stas","Aerogenous Metastasis"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-01T13:15:54.082225Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}