How is lung cancer treated with surgery and what is recovery like?

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1. 1

   Video‐assisted thoracoscopic surgery as the gold standard for lung cancer surgery

   Respirology (Sihoe)Published Jul 30, 2020Checked Oct 14, 2026

   “It can be performed via a traditional open approach (particularly thoracotomy) or a minimally invasive approach. VATS is 'keyhole' surgery in the chest, and was first used for lung cancer resection in the early 1990s. Since then, a large volume of evolving clinical evidence has confirmed that VATS lung cancer resection offered proven safety and feasibility, better patient-reported post-operative outcomes, less surgical trauma as quantified by objective outcome measures and equivalent or better survival than open surgery. This has firmly established VATS as the surgical approach of choice for early-stage lung cancer today. Although impressive new non-surgical lung cancer therapies have emerged in recent years, VATS is also being constantly rejuvenated by the development of 'next generation' VATS techniques, the refinement of VATS sublobar resection for selected patients, the utilization of bespoke post-operative recovery programmes for VATS and the synthesis of VATS into multi-modality lung cancer therapy. There is little doubt that VATS will remain as the gold standard for lung cancer surgery for the foreseeable future.”

2. 2

   National trends, variation and short-term outcomes in surgery for non-small cell lung cancer in England, 2015-2023: a population-based cohort study using linked national cancer registration and hospital administrative data.

   BMJ open (Dixon et al.)Published Sep 16, 2026Checked Oct 14, 2026

   “The resection rate increased from 15.4% in 2015 to 20.9% in 2023, while the proportion of patients diagnosed with stage I disease increased from 17.4% to 26.8%. Segmentectomy use increased from 11.2% to 20.6%, pneumonectomy declined fourfold and minimally invasive surgery increased from 47.1% to 79.7%. In 2023, centre-level variation was marked in segmentectomy for small stage IA tumours (risk-adjusted range 10.7%-80.3%) and RATS use (range 0%-67%). 90-day mortality decreased from 4.03% to 2.26%, length of stay shortened and readmission remained stable at approximately 10%-12%. Each successive year of diagnosis was associated with lower 90-day mortality after adjustment for case mix (adjusted OR 0.95, 95% CI 0.93 to 0.98).ConclusionsBetween 2015 and 2023, surgical management of NSCLC in England changed substantially, with increased resection rates, greater use of segmentectomy and minimally invasive approaches and improved short-term postoperative outcomes. However, persistent variation in segmentectomy use and robotic adoption suggests that implementation of contemporary surgical practice remains heterogeneous across centres.”

3. 3

   The effect of the enhanced recovery after surgery program on lung cancer surgery: a systematic review and meta-analysis

   Journal of Thoracic Disease (Li et al.)Published Jun 1, 2021Checked Oct 14, 2026

   “A total of 21 studies with 6,480 patients were included. The meta-analysis indicated that patients in the ERAS group had a significantly reduced risk of postoperative complications (RR =0.64; 95% CI: 0.52 to 0.78) and shortened postoperative length of stay (SMD=-1.58; 95% CI: -2.38 to -0.79) with a significant heterogeneity. Subgroup analysis showed that the risks of pulmonary (RR =0.58; 95% CI: 0.45 to 0.75), cardiovascular (RR =0.73; 95% CI: 0.59 to 0.89), urinary (RR =0.53; 95% CI: 0.32 to 0.88), and surgical complications (RR =0.64; 95% CI: 0.42 to 0.97) were significantly lower in the ERAS group. No significant reduction was found in the in-hospital mortality (RD =0.00; 95% CI: -0.01 to 0.00) and readmission rate (RR =1.00; 95% CI: 0.76 to 1.32). In the qualitative review, most of the evidence reported significantly decreased hospitalization costs in the ERAS group. The implementation of an ERAS program for surgery of lung cancer can effectively reduce risks of postoperative complications, length of stay, and costs of patients who have undergone lung cancer surgery without compromising their safety.”

4. 4

   Outcomes of enhanced recovery after surgery in lung cancer: A systematic review and meta-analysis

   Asia-Pacific Journal of Oncology Nursing (Zhang et al.)Published Jun 29, 2022Checked Oct 14, 2026

   “Finally, 23 studies were included (12 cohort studies and 11 randomized controlled trials) with a total of 8094 patients. Meta-analysis showed that ERAS significantly reduced visual analog scale scores (mean difference [MD] = −1.99, 95% confidence interval [CI] = −2.45, −1.54, P < 0.01), reduced the incidence of complications (odds ratio=0.48, 95% CI=0.37, 0.61, P < 0.01), shortened chest tube indwelling time (MD = −2.20, 95% CI=−2.75, −1.64, P < 0.01), accelerated first ambulation (MD = −1.48, 95% CI=−1.77, −1.19, P < 0.01), shortened length of stay (MD = −2.70, 95% CI=−3.05, −2.36, P < 0.01), and improved quality of life (MD = 10.3, 95% CI=9.59, 11.02, P < 0.01). ERAS can accelerate postoperative recovery and improve quality of life. These findings support the use of ERAS as a standard of care for lung cancer surgery patients. However, the evidence quality was moderate and there were significant differences among studies. More high-quality studies incorporating relevant outcomes are needed for confirmation.”

5. 5

   Correlation Between Pain Intensity and Quality of Recovery After Video-Assisted Thoracic Surgery for Lung Cancer Resection

   Journal of Pain Research (Yoon et al.)Published Oct 1, 2023Checked Oct 14, 2026

   “We analyzed a total of 137 eligible patients. Significant negative correlations were noted between the QoR-15K total score and pain intensity at rest ( ρ = − 0.45, 95% confidence interval [CI]: − 0.57 − − 0.31, P < 0.001) and during coughing ( ρ = − 0.55, 95% CI: − 0.65 − − 0.42, P < 0.001) at 48 hours postoperatively. The pain dimension and pain intensity at 48 hours postoperatively showed significant correlations with physical comfort, emotional state, and physical independence dimensions. Multivariable logistic regression revealed a significant negative association between the pain score at 24 hours postoperatively and good or excellent postoperative recovery. The results support the impact of postoperative pain on the overall postoperative quality of recovery in patients who underwent VATS for lung cancer resection. Moreover, the QoR-15K score may be considered as a primary endpoint in clinical studies on postoperative pain control. Keywords: pain, postoperative, patient-reported outcome measures, perioperative care, perioperative medicine, thoracic surgery, video-assisted”

6. 6

   Enhanced recovery programs in lung cancer surgery: systematic review and meta-analysis of randomized controlled trials.

   Cancer management and research (Li et al.)Published Nov 16, 2017Checked Oct 14, 2026

   “Relative risk (RR) and weighted mean difference served as the summarized statistics for the meta-analyses. Additional analyses were also performed to perceive potential bias risks.ResultsA total of seven RCTs enrolling 486 patients were included. The meta-analysis indicated that the ERAS group patients had significantly lower morbidity rates (RR=0.64; ppp=0.010), than those of control group patients. No significant reduction was found in the in-hospital mortality (RR=0.70; p=0.58) or cardiovascular complications (RR=1.46; p=0.25). In the qualitative review, most of the evidence reported significantly shortened length of hospital and intensive care unit stay and decreased hospitalization costs in the ERAS-treated patients. No significant publication bias was detected in the meta-analyses.ConclusionOur review demonstrates that the implementation of an ERAS program for lung cancer surgery can effectively accelerate postoperative recovery and save hospitalization costs without compromising patients' safety. A worldwide consensus guideline is urgently required to standardize the ERAS protocols for elective lung resections in the future.”

7. 7

   Effects of enhanced recovery after surgery and prehabilitation interventions on postoperative outcomes after lung resection in patients with lung cancer: a systematic review and meta-analysis

   Frontiers in Public Health (Kim & Shin)Published Oct 5, 2026Checked Oct 14, 2026

   “Ten RCTs involving 1,569 participants met the inclusion criteria. ERAS and prehabilitation significantly reduced PPCs compared with conventional perioperative care (OR = 0.48, 95% CI = 0.36–0.65, p < 0.001). The exploratory pooled analysis suggested a shorter postoperative LOS (MD = −2.30 days, 95% CI = −3.58 to −1.01); however, heterogeneity was considerable ( I 2 = 97.9%), and the 95% prediction interval crossed the null. Narrative synthesis demonstrated consistent improvements in anxiety, depression, postoperative pain, pulmonary function, quality of life, and functional recovery. ERAS and prehabilitation are effective perioperative strategies for improving outcomes after pulmonary resection for lung cancer. Their implementation in routine clinical practice may reduce postoperative complications, accelerate recovery, and improve healthcare efficiency. Further multicenter RCTs are needed to optimize intervention components, standardize outcome measures, and strengthen evidence for long-term and patient-reported outcomes.”