(Barcelona, Spain September 8, 2025, 10:45 a.m. CEST / UTC +2) – Patients who underwent video-assisted thoracoscopic surgery (VATS) compared to open lobectomy had a significantly improved overall survival rate, according to a meta-analysis presented at the International Association for the Study of Lung Cancer (IASLC) 2025 World Conference on Lung Cancer (WCLC).
Video-assisted thoracoscopic surgery (VATS) is currently the most common approach to perform pulmonary lobectomy in early-stage lung cancer. Advantages include reduced pain, fewer complications, faster recovery and improved quality-of-life. The adoption of VATS lobectomy is based on proven non-oncological benefits.
According to Dr. Jacie Jiaqi Law, Royal Brompton Hospital, United Kingdom, none of the three largest contemporary randomized trials completed have been powered to detect a difference in overall or disease-free survival. Several meta-analyses of predominantly non-randomized studies have suggested a VATS approach leads to improved patient survival compared to thoracotomy, however findings are limited due to selection bias and confounding, Dr. Law reported.
To answer this important question, Dr. Law and fellow researchers sought to identify randomized trials comparing VATS and open lobectomy in early-stage lung cancer and obtain individual patient data from these trials to conduct a meta-analysis.
Of the 556 potential studies identified, only three were randomised trials that met the eligibility criteria: Bendixen et al. from Denmark (NCT01278888), Long et al. from China (NCT01102517) and Lim et al. from the United Kingdom (NCT03521375). Data on 1185 patients (586 randomized to VATS and 599 randomized to open lobectomy) was provided from the three trials.
The primary analysis indicated significantly improved overall survival for patients randomized to VATS compared to open lobectomy, pooled hazard ratio (HR) 0.79 (95% confidence interval (CI) 0.65-0.96), representing a 21% reduction in the risk of death in the VATS lobectomy group. There was no difference in disease-free survival, pooled HR 0.91 (95% CI 0.75-1.12).
“For the first time, we provide evidence that a simple change in surgical access to VATS reduces the overall risk of death by 21% without any compromise to disease-free survival,” Dr. Law reported. “These results underscore the importance of prioritizing VATS when technically feasible as the access of choice for surgical resection of early-stage non-small cell lung cancer.”
About the IASLC:
The International Association for the Study of Lung Cancer (IASLC) is the only global organization dedicated solely to the study of lung cancer and other thoracic malignancies. Founded in 1974, the association's membership includes more than 10,000 lung cancer specialists across all disciplines in over 100 countries, forming a global network working together to conquer lung and thoracic cancers worldwide. The association also publishes the Journal of Thoracic Oncology, the primary educational and informational publication for topics relevant to the prevention, detection, diagnosis, and treatment of all thoracic malignancies. Visit www.iaslc.org for more information.
About the WCLC:
The WCLC is the world’s largest meeting dedicated to lung cancer and other thoracic malignancies, attracting nearly 7,000 researchers, physicians, and specialists from more than 100 countries. The goal is to increase awareness, collaboration and understanding of lung cancer, and to help participants implement the latest developments across the globe. The conference will cover a wide range of disciplines and unveil several research studies and clinical trial results. For more information, visit https://wclc.iaslc.org/.