Video-assisted thoracoscopic surgery (VATS) was linked to a 21% reduction in risk of death vs open lobectomy for early-stage non-small cell lung cancer (NSCLC) in a meta-analysis of randomized trials presented at 2025 World Conference on Lung Cancer. Investigators noted this overall-survival (OS) advantage came without a trade-off in disease-free survival (DFS), strengthening the case for prioritizing VATS as the default surgical access when feasible—on top of its known benefits of less pain, fewer complications, faster recovery, and better quality of life.
The team systematically identified 3 high-quality randomized controlled trials (Denmark: Bendixen et al., NCT01278888; China: Long et al., NCT01102517; UK: Lim et al., NCT03521375) totaling 1,185 patients randomized to VATS (n=586) or open lobectomy (n=599). Baseline characteristics were well balanced (minor age differences), and risk of bias was low. Pooled hazard ratios favored VATS for OS (hazard ratio [HR] 0.79; 95% confidence interval [CI] 0.65–0.96) with no significant difference in DFS (HR 0.91; 95% CI 0.75–1.12). Results were consistent after excluding benign disease (OS HR 0.78; DFS HR 0.89), and there was no interaction by age for OS (P=.83) or DFS (P=.43), suggesting a broadly applicable survival benefit.
Reference: The ASCO Post Staff. Overall Survival Risk for VATS vs Open Lobectomy for Early Lung Cancer. The ASCO Post. Published September 11, 2025. Accessed September 16, 2025. https://ascopost.com/news/september-2025/overall-survival-risk-for-vats-vs-open-lobectomy-for-early-lung-cancer/ The ASCO Post Staff. Overall Survival Risk for VATS vs Open Lobectomy for Early Lung Cancer. The ASCO Post. Published September 11, 2025. Accessed September 16, 2025. https://ascopost.com/news/september-2025/overall-survival-risk-for-vats-vs-open-lobectomy-for-early-lung-cancer/
