{"entity":{"id":"calgb-140503","kind":"trial","name":"CALGB 140503 (Alliance)","aka":[],"tldr":"CALGB 140503 showed that removing only part of a lobe is as good as removing the whole lobe for small peripheral lung cancers, so screen-detected tumours can be cured with less lung taken out.","summary":"CALGB 140503 randomised 697 patients with a peripheral non-small-cell lung cancer of 2 cm or less and nodes confirmed negative at surgery to sublobar resection (segmentectomy or wedge) or lobectomy. Lobectomy had been the standard since the 1995 Lung Cancer Study Group trial, which found more recurrences after limited resection, but that trial predated CT screening and modern staging.\n\nFive-year disease-free survival was 63.6 percent after sublobar resection and 64.1 percent after lobectomy (hazard ratio 1.01, non-inferior), and five-year overall survival was 80.3 percent and 78.9 percent. Locoregional recurrence was no higher after sublobar resection, and lung function at six months was slightly better preserved.\n\nWith the Japanese JCOG0802 trial, which found segmentectomy at least as good as lobectomy for the same tumours, the trial changed guidelines: sublobar resection is now an accepted standard for small peripheral node-negative tumours, which are the ones low-dose CT screening finds.","status":"positive","asOf":"2026-09-17","links":[{"label":"ClinicalTrials.gov NCT00499330","url":"https://clinicaltrials.gov/study/NCT00499330"},{"label":"New England Journal of Medicine 2023","url":"https://doi.org/10.1056/NEJMoa2212083"}],"tags":[],"related":[],"cancers":["nsclc","resectable-nsclc"],"sections":[],"technologies":["robotic-surgery","low-dose-ct-screening"],"targets":[],"drugs":[],"companies":[],"institutions":["alliance-oncology"],"pathways":[],"terms":["lobectomy","segmentectomy","minimally-invasive-surgery"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT00499330","phase":"3","setting":"Peripheral clinical stage IA non-small-cell lung cancer 2 cm or smaller with negative hilar and mediastinal nodes: sublobar resection (wedge or segmentectomy) versus lobectomy","sponsor":"Alliance for Clinical Trials in Oncology / NCI","result":"5-year disease-free survival 63.6% (sublobar) vs 64.1% (lobectomy), non-inferior; 5-year overall survival 80.3% vs 78.9%.","yearReported":2023,"enrolled":697,"outcomes":[{"endpoint":"Disease-free survival at 5 years","primary":true,"unit":"%","arms":[{"name":"Sublobar resection","n":340,"value":63.6},{"name":"Lobectomy","n":357,"value":64.1}],"hr":1.01,"source":"https://doi.org/10.1056/NEJMoa2212083"},{"endpoint":"Overall survival at 5 years","unit":"%","arms":[{"name":"Sublobar resection","n":340,"value":80.3},{"name":"Lobectomy","n":357,"value":78.9}],"source":"https://doi.org/10.1056/NEJMoa2212083"}],"replication":"JCOG0802/WJOG4607L (Japan, 2022) found segmentectomy non-inferior for recurrence-free survival and superior for overall survival in the same tumour size range."},"route":"/trials/calgb-140503/","neighbours":{"cancer":[{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"resectable-nsclc","kind":"cancer","name":"Resectable stage I to III non-small-cell lung cancer","route":"/cancers/resectable-nsclc/"}],"technology":[{"id":"low-dose-ct-screening","kind":"technology","name":"Low-dose CT lung screening","route":"/technologies/low-dose-ct-screening/"},{"id":"robotic-surgery","kind":"technology","name":"Robotic & minimally invasive surgery","route":"/technologies/robotic-surgery/"}],"institution":[{"id":"alliance-oncology","kind":"institution","name":"Alliance for Clinical Trials in Oncology","route":"/institutions/alliance-oncology/"}],"term":[{"id":"lobectomy","kind":"term","name":"Lobectomy","route":"/terms/lobectomy/"},{"id":"minimally-invasive-surgery","kind":"term","name":"Minimally invasive surgery (laparoscopic, robotic, VATS)","route":"/terms/minimally-invasive-surgery/"},{"id":"segmentectomy","kind":"term","name":"Segmentectomy (sublobar resection)","route":"/terms/segmentectomy/"}]}}