23 March 2026
A recent study has found that patients with early‑stage non‑small cell lung cancer tend to live longer when their lung surgery is carried out using a minimally invasive technique called video-assisted thoracoscopic surgery (VATS), compared to traditional open surgery.
Published in The Lancet, and led by Professor Eric Lim, consultant thoracic surgeon at Royal Brompton Hospital, the study explored for the first time whether the type of operation approach to remove the lung tumour has a direct impact on patient survival. The findings represent an important step forward in understanding how surgical technique can influence outcomes for people with lung cancer.
Patients with early-stage lung cancer may require a procedure called pulmonary lobectomy, where one lobe of the lung is removed to remove the disease and prevent it from progressing. Previously this was done through traditional open surgery, which involved a large incision between the ribs. However, today a much less invasive method, known as VATS, has become the most common approach.
VATS uses a small camera (thoracoscope), and specialised instruments inserted through small incisions in the chest, allowing surgeons to remove the affected lung tissue without making a large opening. This minimally invasive technique has largely replaced traditional open surgery because it offers several benefits, including reduced pain, fewer complications, faster recovery and a better quality of life after the operation.
The study brought together information from international randomised controlled trials to better understand how two approached for lung cancer surgery compare. By combining the trials, the research team was able to look at a much larger group of patients, which helps make the findings more reliable. Only studies that followed adults treated for early-stage lung cancer and tracked how well they recovered were included. Altogether, the research covered 1185 patients: 586 had VATS surgery and 599 had open surgery.
The study found that patients who had VATs surgery had a better survival rate, with a 21% reduction in risk of death (mortality risk), compared with traditional open surgery. It further demonstrated that both groups had similar rates of remaining disease free. Overall, the researchers concluded that for patients who are suitable for either option, VATS should be the preferred approach.
When commenting on the study Professor Lim stated:
“It was a privilege to lead this international study, spanning Europe to Asia, which pooled data from rigorously conducted clinical trials of lung cancer surgery to demonstrate the far-reaching implications of the VATS surgical approach - not only for improved quality of life, but, for the first time, we showed it increases patient survival.”
Click here to read the full paper.
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