Twenty-four studies (11,360 participants, ranging from 73 to 1,272) were included in the review. All studies were retrospective, except for one randomised controlled trial (RCT).
Sublobectomy versus lobectomy overall: Lobectomy was significantly associated with improved overall survival (HR 1.26, 95% CI 1.07 to 1.47; significant heterogeneity; 22 studies), improved cancer-specific survival (HR 2.07, 95% CI 1.14 to 3.77; significant heterogeneity; six studies) and improved overall or cancer-specific survival (HR 1.40, 95% CI 1.15 to 1.69; significant heterogeneity).
Sublobectomy versus lobectomy in participants with tumours 2cm or smaller: There was no evidence of a significant difference in overall survival when lobectomy was compared with sublobectomy in participants with tumours 2cm or smaller (HR 0.81, 95% CI 0.39 to 1.71; no significant heterogeneity (p=0.06); five studies).
Segmentectomy versus lobectomy: There was no evidence of a significant difference in either overall survival (HR 1.09, 95% CI 0.85 to 1.40; no significant heterogeneity; eight studies), cancer-specific survival (HR 0.99, 95% CI 0.72 to 1.38; no significant heterogeneity; three studies) or combined overall or cancer-specific survival (HR 1.05, 95% CI 0.87 to 1.28; no significant heterogeneity).
There was no evidence of publication bias in any of the analyses.